ABSTRACT

Objective

There is not enough data on the effect of angiotensin-converting enzyme inhibitors (ACEIs)/angiotensin receptor blockers (ARBs) on lung involvement in patients with COVID-19 pneumonia and hypertension (HT). Our aim was to compare the lung involvement of the HT patients hospitalized for COVID-19 using ACEIs/ARBs with the patients taking other anti-HT medications.

Methods

: Patients who have a diagnosis of HT among the patients treated for laboratory-confirmed COVID-19 between 31 March 2020 and 28 May 2020 were included in the study. One hundred and twenty-four patients were divided into two as ACEIs/ARBs group (n = 75) and non-ACEIs/ARBs group (n = 49) according to the anti-HT drug used. The chest CT involvement areas of these two groups were evaluated quantitatively by two observers including all lobes, and total severity score (TSS) was calculated. These TSS values were compared between drug groups and clinical groups

Results

In clinical classification; there were 4 (%3.2) asymptomatic, 5 (4.0%) mild type, 92 (74.1%) common type, 14 (11.3%) severe type, 9 (7.3%) critical type patients. ACEI/ARB group’s TSS (mean±SD, 7.74 ± 3.54) was statistically higher than other anti-HT medication group (mean±SD, 4.40 ± 1.89) (p < .001). Likewise, severe-critical clinical type’s TSS (mean±SD, 9.17 ± 3.44) was statistically higher than common type (mean±SD, 5.76 ± 3.07) (p < .001). Excellent agreement was established between the two blinded observers in the TSS measurements.

Conclusions

Quantitative evaluation of CT and TSS score can give an idea about the clinical classification of the patient. TSS is higher in ACEI/ARB group than non-ACEIs/ARBs group.

中文翻译：

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冠状病毒病（COVID-19）高血压患者的CT视觉定量评估：血管紧张素转换酶抑制剂/血管紧张素受体阻滞剂对肺部受累严重程度的潜在影响

摘要

客观的

关于血管紧张素转换酶抑制剂 (ACEIs)/血管紧张素受体阻滞剂 (ARB) 对 COVID-19 肺炎和高血压 (HT) 患者肺部受累的影响，尚无足够的数据。我们的目的是比较因 COVID-19 住院且使用 ACEI/ARB 的 HT 患者与服用其他抗 HT 药物的患者的肺部受累情况。

方法

：2020年3月31日至2020年5月28日期间接受实验室确诊的COVID-19治疗的患者中被诊断为HT的患者被纳入该研究。124例患者根据所用抗HT药物分为ACEIs/ARBs组（n = 75）和非ACEIs/ARBs组（n = 49）两类。由两名观察者对两组胸部CT受累面积（包括所有肺叶）进行定量评估，并计算总严重程度评分（TSS）。这些 TSS 值在药物组和临床组之间进行比较

结果

在临床分类中；无症状患者4例（%3.2），轻度型5例（4.0%），普通型92例（74.1%），重症14例（11.3%），危重型9例（7.3%）。ACEI/ARB 组的 TSS（平均值±SD，7.74 ± 3.54）在统计学上高于其他抗HT 药物组（平均值±SD，4.40 ± 1.89）（p < .001）。同样，重症危重症临床类型的 TSS（平均值±SD，9.17 ± 3.44）在统计学上高于普通型（平均值±SD，5.76 ± 3.07）（p < .001）。在 TSS 测量中，两个盲人观察者之间建立了良好的一致性。

结论

CT和TSS评分的定量评估可以了解患者的临床分类。ACEI/ARB 组的 TSS 高于非 ACEI/ARB 组。