Sharma Ruchika, Kumar Anoop, Majeed Jaseela, Thakur Ajit K, Aggarwal Geeta
Centre for Precision Medicine and Pharmacy, Delhi Pharmaceutical Sciences and Research University, New Delhi, 110017, India.
Department of Pharmacology, Delhi Pharmaceutical Sciences and Research University (DPSRU), New Delhi, 110017, India.
Egypt Heart J. 2022 Sep 6;74(1):64. doi: 10.1186/s43044-022-00303-8.
Angiotensin-converting enzyme inhibitors (ACEi) and angiotensin receptor blockers (ARBs) are two of the most commonly used antihypertensive drugs acting on the renin-angiotensin-aldosterone system (RAAS). Previous research has shown that RAAS inhibitors increase the expression of angiotensin-converting enzyme, a cellular receptor for the severe acute respiratory syndrome coronavirus 2, raising concerns that the use of ACEi and ARBs in hypertensive patients may increase COVID-19 patient mortality. Therefore, the main aim of the current study was to find out the role of drugs acting on RAAS, particularly ACEi/ARBs in the deaths of COVID-19 patients.
In total, 68 studies were found to be appropriate, reporting a total of 128,078 subjects. The odds ratio was found to be 1.14 [0.95, 1.36], which indicates the non-significant association of ACEi/ARBs with mortality of COVID-19 patients. Further, the association of individual ACEi/ARBs with mortality of COVID-19 patients was also found non-significant. The sensitivity analysis results have shown no significant effect of outliers on the outcome.
Based on available evidence, ACEi/ARB were not significantly associated with deaths of COVID-19 patients.
血管紧张素转换酶抑制剂（ACEi）和血管紧张素受体阻滞剂（ARBs）是作用于肾素-血管紧张素-醛固酮系统（RAAS）的两种最常用的抗高血压药物。先前的研究表明，RAAS抑制剂会增加血管紧张素转换酶（严重急性呼吸综合征冠状病毒2的细胞受体）的表达，这引发了人们对高血压患者使用ACEi和ARBs可能会增加COVID-19患者死亡率的担忧。因此，本研究的主要目的是查明作用于RAAS的药物，特别是ACEi/ARBs在COVID-19患者死亡中的作用。
总共发现68项研究合适，报告的受试者总数为128,078名。优势比为1.14 [0.95, 1.36]，这表明ACEi/ARBs与COVID-19患者死亡率之间无显著关联。此外，还发现个体ACEi/ARBs与COVID-19患者死亡率之间的关联也不显著。敏感性分析结果表明，异常值对结果无显著影响。
根据现有证据，ACEi/ARB与COVID-19患者死亡无显著关联。
