Wen Ru, Li Jinwen, Chen Fengxi, Liu Jian, Xu Peng, Li Mengfei, Li Jingwei, Tan Liang, Liu Chen
Department of Radiology, Southwest Hospital, Army Medical University (Third Military Medical University), Chongqing, China.
Department of Medical Imaging, Guizhou Provincial People's Hospital, Guiyang, Guizhou, China.
Hypertens Res. 2025 Jan;48(1):273-283. doi: 10.1038/s41440-024-01953-8. Epub 2024 Nov 6.
We examined the relationship between RAAS inhibitor use and Omicron infection in mildly symptomatic patients. This retrospective case-control observational study included 50,121 patients with mild Omicron infection from the largest "Fangcang" shelter hospital in Shanghai between April 9, 2022, and May 21, 2022. Using 1:1 propensity score matching (PSM), we classified 4394 COVID-19 patients into hypertension and non-hypertension groups, and 406 hypertensive patients into RAAS inhibitor and non-RAAS inhibitor groups. The risk of initial symptoms of infection, cumulative negative conversion rates, time to nucleic-acid negative conversion, and viral loads were compared. In the hypertension group, the median number of days for nucleic-acid negative conversion was 7.0 (IQR, 5.0-9.0), which was greater than non-hypertensive group (median (IQR) 6.0 (4.0-8.0), P < 0.001, Cohen's d = 0.29); the mean and minimum cycle threshold values (CT-values) were significantly lower (P < 0.001, Cohen's d = 0.23). In the RAAS inhibitors group, the median number of days for nucleic-acid negative conversion was 7.0 days (IQR, 5.0-9.0), which was shorter than the non-RAAS inhibitors group ([median (IQR)] 8.0 (6.0-10.0), P < 0.001, Cohen's d = 0.34), the cumulative negative conversion rates at 3-8 days being all higher than non-RAAS inhibitors groups (P < 0.05). The most significant difference in negative conversion rate between the RAAS inhibitor and non-RAAS inhibitor group was on the 4th day. No significant difference was observed in mean and minimum CT-values from RAAS inhibitor and non-RAAS inhibitor groups (P > 0.05). RAAS inhibitor use in patients with hypertension is associated with nucleic-acid negative conversion duration and negative conversion rate. RAAS inhibitors clearly do not aggravate or prolong COVID-19.
我们研究了轻度症状患者使用肾素-血管紧张素-醛固酮系统（RAAS）抑制剂与感染奥密克戎之间的关系。这项回顾性病例对照观察性研究纳入了2022年4月9日至2022年5月21日期间来自上海最大的“方舱”医院的50121例轻度奥密克戎感染患者。采用1:1倾向评分匹配（PSM），我们将4394例新冠患者分为高血压组和非高血压组，并将406例高血压患者分为RAAS抑制剂组和非RAAS抑制剂组。比较了感染初始症状的风险、累积转阴率、核酸转阴时间和病毒载量。在高血压组中，核酸转阴的中位天数为7.0天（四分位间距，5.0 - 9.0），高于非高血压组（中位值（四分位间距）6.0（4.0 - 8.0），P < 0.001，科恩d值 = 0.29）；平均和最低循环阈值（CT值）显著更低（P < 0.001，科恩d值 = 0.23）。在RAAS抑制剂组中，核酸转阴的中位天数为7.0天（四分位间距，5.0 - 9.0），短于非RAAS抑制剂组（[中位值（四分位间距）]8.0（6.0 - 10.0），P < 0.001，科恩d值 = 0.34），3 - 8天的累积转阴率均高于非RAAS抑制剂组（P < 0.05）。RAAS抑制剂组和非RAAS抑制剂组之间转阴率的最显著差异出现在第4天。RAAS抑制剂组和非RAAS抑制剂组的平均和最低CT值未观察到显著差异（P > 0.05）。高血压患者使用RAAS抑制剂与核酸转阴持续时间和转阴率相关。RAAS抑制剂显然不会加重或延长新冠病程。
