Department of Cardiology, Ambroise Paré Hospital, Assistance Publique-Hôpitaux de Paris (AP-HP), Centre de référence des cardiomyopathies et des troubles du rythme cardiaque héréditaires ou rares, Université de Versailles-Saint Quentin (UVSQ), Boulogne-Billancourt, France; INSERM U-1018, CESP, Epidémiologie clinique, UVSQ, Université de Paris Saclay, Villejuif, France.
Department of Cardiology, Ambroise Paré Hospital, Assistance Publique-Hôpitaux de Paris (AP-HP), Centre de référence des cardiomyopathies et des troubles du rythme cardiaque héréditaires ou rares, Université de Versailles-Saint Quentin (UVSQ), Boulogne-Billancourt, France.
Am J Cardiol. 2021 May 15;147:58-60. doi: 10.1016/j.amjcard.2021.02.009. Epub 2021 Feb 20.
Effect of angiotensin-converting enzyme inhibitors (ACEI) and angiotensin II receptor blockers (ARB) among hypertensive patients with coronavirus disease 2019 (COVID-19) is debated. The aim of the COVIDECA study was to assess the outcome of ACEI and ARB among hypertensive patients presenting with COVID-19. We reviewed from the Assistance Publique-Hôpitaux de Paris healthcare record database all patients presenting with confirmed COVID-19 by RT-PCR. We compared hypertensive patients with ACEI or ARB and hypertensive patients without ACEI and ARB. Among 13,521 patients presenting with confirmed COVID-19 by RT-PCR, 2,981 hypertensive patients (mean age: 78.4 ± 13.6 years, 1,464 men) were included. Outcome of hypertensive patients was similar whatever the use or non-use of ACEI or ARB: admission in ICU (13.4% in patients with ACEI or ARB versus 14.8% in patients without ACEI/ARB, p = 0.35), need of mechanical ventilation (5.5% in patients with ACEI or ARB vs 6.3% in patients without ACEI/ARB, p = 0.45), in-hospital mortality (27.5% in patients with ACEI or ARB vs 26.7% in patients without ACEI/ARB, p = 0.70). In conclusion, the use of ACEI and ARB remains safe and can be maintained in hypertensive patients presenting with COVID-19.
血管紧张素转换酶抑制剂（ACEI）和血管紧张素 II 受体阻滞剂（ARB）在伴有 2019 冠状病毒病（COVID-19）的高血压患者中的作用存在争议。COVIDECA 研究的目的是评估 ACEI 和 ARB 在伴有 COVID-19 的高血压患者中的结局。我们从巴黎公立医院集团医疗记录数据库中回顾了所有经 RT-PCR 确诊的 COVID-19 患者。我们比较了使用 ACEI 或 ARB 的高血压患者与未使用 ACEI 和 ARB 的高血压患者。在经 RT-PCR 确诊的 13521 例 COVID-19 患者中，纳入了 2981 例高血压患者（平均年龄：78.4 ± 13.6 岁，1464 例男性）。无论是否使用 ACEI 或 ARB，高血压患者的结局相似：入住 ICU（ACEI 或 ARB 组 13.4%，无 ACEI/ARB 组 14.8%，p=0.35）、需要机械通气（ACEI 或 ARB 组 5.5%，无 ACEI/ARB 组 6.3%，p=0.45）、院内死亡率（ACEI 或 ARB 组 27.5%，无 ACEI/ARB 组 26.7%，p=0.70）。总之，在伴有 COVID-19 的高血压患者中，使用 ACEI 和 ARB 仍然是安全的，可以维持治疗。
