Department of Cardiology, The First Affiliated Hospital of Chongqing Medical University, Chongqing 400016, China.
Department of Emergency, Traditional Chinese Medicine Hospital Dianjiang Chongqing, Chongqing 408300, China.
Aging (Albany NY). 2020 Nov 16;12(23):23436-23449. doi: 10.18632/aging.104019.
The aim of this study is to investigate clinical characteristics and fatal outcomes of hypertension as well as the role of angiotensin-converting enzyme inhibitors/angiotensin receptor blockers (ACEI/ARB) use in patients with severe coronavirus disease 2019 (COVID-19). A total of 220 (female: 51.8%) patients with severe COVID-19 were included. The mean age of included patients was 59.5 years and 70 (31.8%) patients had a history of hypertension. There were 23 patients (32.9%) receiving ACEI/ARB therapy. Patients with hypertension were older and had more comorbidities, and were more likely to suffer from severe inflammatory response and acute cardiac injury. Moreover, patients with hypertension were associated with significantly higher risk of in-hospital mortality than patients without hypertension. After adjustment of potential confounders, the independent correlation was still observed. In addition, ACEI/ARB users were associated with lower level of high-sensitivity cardiac troponin I and creatinine kinase-myocardial band, and lower risk of acute cardiac injury than ACEI/ARB non-users. In conclusion, patients with hypertension were more likely to suffer from severe inflammatory response, acute cardiac injury and had high risk of in-hospital mortality in severe COVID-19. The use of ACEI/ARB may protect patients with COVID-19 from acute cardiac injury.
本研究旨在探讨高血压的临床特征和致死结局，以及血管紧张素转换酶抑制剂/血管紧张素受体阻滞剂（ACEI/ARB）在重症 2019 冠状病毒病（COVID-19）患者中的作用。共纳入 220 例（女性：51.8%）重症 COVID-19 患者。纳入患者的平均年龄为 59.5 岁，70 例（31.8%）有高血压病史。23 例（32.9%）患者接受 ACEI/ARB 治疗。高血压患者年龄较大，合并症较多，更易发生严重炎症反应和急性心脏损伤。此外，高血压患者的住院病死率明显高于无高血压患者。调整潜在混杂因素后，仍观察到独立相关性。此外，ACEI/ARB 使用者的高敏心肌肌钙蛋白 I 和肌酸激酶同工酶-MB 水平较低，急性心脏损伤风险较低，与 ACEI/ARB 非使用者相比。总之，重症 COVID-19 患者中高血压患者更易发生严重炎症反应、急性心脏损伤，住院病死率高。ACEI/ARB 的使用可能使 COVID-19 患者免于急性心脏损伤。
