ABSTRACT

Introduction

We have aimed to investigate the relationship between use of angiotensin-converting-enzyme inhibitor (ACEI) or angiotensin-receptor-blocker (ARB) drugs and acute hypoxemic respiratory failure (AHRF) and in-hospital mortality in hypertensive Covid-19 patients.

Material and method

Consecutive 1345 patients diagnosed with Covid-19 between April and October 2020 who met inclusion criteria were divided into two groups based on presence and absence of AHRF and mortality. The groups were compared regarding epidemiological, clinical, radiological, laboratory findings and treatments methods. The patient groups ACEI, ARB and other antihypertensive drugs (non-ACEI/ARB) were compared regarding same parameters.

Results

Median age was 68 (60–76) years in the patient group including 805 (59.9.1%) females. Of the patients, 475 (35.3%), 644 (47.9%) and 226 (16.8%) were using ACEIs, ARBs and non-ACEI/ARB, respectively. AHRF and in-hospital mortality developed in 1053 (78.3%) and 290 (21.6%) patients, respectively. Age, gender, coronary artery disease, diabetes mellitus (DM), neutrophil, lymphocyte, creatinine, D-dimer, C-reactive protein (CRP), ACEI, beta blocker and aspartate transaminase (AST) found statistically significant in the univariable logistic regression performed to identify independent predictors of mortality were included multivariable logistic regression model. Age (OR: 1.066, 95%CI: 1.049–1.083; p < .001), DM (OR: 1.682, 95%CI: 1.238–2.286; p = .001), neutrophil (OR: 1.041, 95%CI: 1.007–1.077; p = .019), creatinine (OR: 1.178, 95%CI: 1.048–1.325; p = .006), CRP (OR: 1.008, 95%CI: 1.006–1.010; p < .001), ACEI (OR: 0.718, 95%CI: 0.521–0.988; p = .042), AST (OR: 1.005, 95%CI: 1.001–1.010; p = .010) were found associated with in-hospital mortality.

Conclusion

In our study, it was not detected clinically significant difference between three groups with regard to their relation with in-hospital mortality.

中文翻译：

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RAAS抑制剂对高血压Covid-19患者急性低氧性呼吸衰竭和院内死亡率的影响

摘要

介绍

我们的目的是调查高血压 Covid-19 患者使用血管紧张素转换酶抑制剂 (ACEI) 或血管紧张素受体阻滞剂 (ARB) 药物与急性低氧性呼吸衰竭 (AHRF) 和院内死亡率之间的关系。

材料与方法

2020 年 4 月至 10 月期间连续诊断出患有 Covid-19 且符合纳入标准的 1345 名患者根据是否存在 AHRF 和死亡率分为两组。比较各组的流行病学、临床、放射学、实验室检查结果和治疗方法。对ACEI、ARB和其他抗高血压药物（非ACEI/ARB）患者组的相同参数进行比较。

结果

患者组中的中位年龄为 68（60-76）岁，其中包括 805 名（59.9.1%）女性。在这些患者中，分别有 475 例 (35.3%)、644 例 (47.9%) 和 226 例 (16.8%) 使用 ACEI、ARB 和非 ACEI/ARB。分别有 1053 名 (78.3%) 和 290 名 (21.6%) 患者出现 AHRF 和院内死亡。年龄、性别、冠状动脉疾病、糖尿病 (DM)、中性粒细胞、淋巴细胞、肌酐、D-二聚体、C 反应蛋白 (CRP)、ACEI、β 受体阻滞剂和天冬氨酸转氨酶 (AST) 在单变量逻辑回归中具有统计显着性为确定死亡率的独立预测因素而进行的研究包括多变量逻辑回归模型。年龄（OR：1.066，95%CI：1.049–1.083；p < .001）、DM（OR：1.682，95%CI：1.238–2.286；p = .001）、中性粒细胞（OR：1.041，95%CI： 1.007–1.077；p = .019)、肌酐（OR：1.178，95%CI：1.048–1.325；p = .006）、CRP（OR：1.008，95%CI：1.006–1.010；p < .001）、 ACEI（OR：0.718，95%CI：0.521–0.988；p = .042）、AST（OR：1.005，95%CI：1.001–1.010；p = .010）被发现与院内死亡率相关。

结论

在我们的研究中，没有发现三组之间与院内死亡率的关系存在临床显着差异。