Unit of Infectious Diseases, Department of Medical, Surgical and Experimental Sciences, University of Sassari, Sassari, Italy.
Eur Rev Med Pharmacol Sci. 2021 Jan;25(1):523-526. doi: 10.26355/eurrev_202101_24424.
Since the start of the COVID-19 pandemic, millions of people have been infected with thousands of deaths. Few data regarding factors that increase the risk of infection are available. Our study aimed to evaluate all people living in retirement homes (PLRNH) and identify factors that could increase infection risk in a close community.
We conducted a retrospective study enrolling all PLRNH, where at least one SARS-CoV-2 infected person was present. Variables were compared with Student's t-test or Pearson chi-square test as appropriate. Uni- and multivariate analyses were conducted to evaluate variables' influence on the infection.
We included 452 PLRNH; 144 (31.7%) were male, with a mean age of 82.2±8.6 years. People with a positive swab for SARS-CoV-2 were 306 (67.4%). A significant difference between SARS-CoV-2 infected and not infected was observed in the percentage of those receiving chronic treatment with Angiotensin II receptor blockers (ARBs) (18.6% vs. 9.5%, p=0.012). On the contrary, there was no difference in the proportion of those receiving ACE inhibitors (ACE-I) (21.2% vs. 23.6%, p=0.562). At multivariate analysis, people with mental illness and cancer had an increased risk of being infected. Furthermore, receiving ARBs as a chronic treatment was an independent predictor of infection risk [OR 1.95 (95% CI 1.03-3.72) p=0.041].
Our data suggest that, in close communities, such as retirement nursing homes, the receipt of ARBs increased the risk of acquiring SARS-CoV-2 infection. However, before changing an important chronic treatment in a fragile population, such as the elderly living in retirement nursing homes, clinicians should carefully evaluate the risk-benefit ratio.
自 COVID-19 大流行开始以来，数以百万计的人感染了数千人死亡。关于增加感染风险的因素的数据很少。我们的研究旨在评估所有居住在养老院（PLRNH）的人，并确定在一个封闭社区中可能增加感染风险的因素。
我们进行了一项回顾性研究，纳入了至少有一名 SARS-CoV-2 感染者的所有 PLRNH。使用学生 t 检验或皮尔逊卡方检验比较变量，根据需要进行单变量和多变量分析，以评估变量对感染的影响。
我们纳入了 452 名 PLRNH；144 名（31.7%）为男性，平均年龄为 82.2±8.6 岁。有 306 人（67.4%）SARS-CoV-2 拭子检测呈阳性。在接受血管紧张素 II 受体阻滞剂（ARBs）慢性治疗的比例（18.6%比 9.5%，p=0.012）方面，SARS-CoV-2 感染组与未感染组存在显著差异。相反，接受血管紧张素转换酶抑制剂（ACE-I）治疗的比例（21.2%比 23.6%，p=0.562）无差异。多变量分析显示，患有精神疾病和癌症的人感染风险增加。此外，作为慢性治疗接受 ARBs 治疗是感染风险的独立预测因素[比值比（OR）1.95（95%置信区间 1.03-3.72），p=0.041]。
我们的数据表明，在养老院等封闭社区中，接受 ARBs 治疗会增加感染 SARS-CoV-2 的风险。然而，在改变脆弱人群（如居住在养老院的老年人）的重要慢性治疗之前，临床医生应仔细评估风险-收益比。
