The effects of antihypertensive medications on severity and outcomes of COVID19

Risk factors and characteristics of hospitalized COVID-19 patients in Jordan

OBJECTIVES

To investigate the occurrence and identify the factors contributing to hospitalization among individuals diagnosed with COVID-19.

METHODS

From June 15, 2020 to September 30, 2020, a cross-sectional study utilizing an online questionnaire was carried out in Jordan. The study included 657 COVID-19 patients who had recovered and had reached a minimum of 3 months post-illness. Sociodemographic and COVID-19-related data were collected. The questionnaire was distributed to members of the "My Experience with COVID-19 Association" in Jordan.

RESULTS

The prevalence of hospitalization among COVID-19 patients was 3%. Patients with hypertension (p=0.00), diabetes mellitus (p=0.00), and heart disease (p=0.009); using angiotensin-converting enzyme inhibitors (ACE) and angiotensin-receptor blockers (ARBs) (p=0.00); with body mass indexes (BMI) above normal (p=0.005); and aged over 45 years (p=0.00) were at higher risk of hospitalization. Using an odds ratio (OR), hypertension (OR=7.1), diabetes mellitus (OR=11.4), heart disease (OR=6.3), angiotensin-converting enzyme inhibitors and angiotensin-receptor blockers use (OR=10.8), and having a BMI >25 (OR=5) were significant hospitalization risk factors. The seasonal influenza vaccine, smoking, and neuropsychological symptoms showed no significance.

CONCLUSION

Identifying high-risk groups can help them monitor their health and take preventive measures against COVID-19 infection.

Association of Cardiovascular Medications With Adverse Outcomes in a Matched Analysis of a National Cohort of Patients With COVID-19

Background

The use of statins, angiotensin-converting enzyme inhibitors (ACEIs)/angiotensin II receptor blockers (ARBs), and anticoagulants may be associated with fewer adverse outcomes in COVID-19 patients.

Methods

Nested within a cohort of 800,913 patients diagnosed with COVID-19 between April 1, 2020 and June 24, 2021 from the Optum COVID-19 database, three case-control studies were conducted. Cases-defined as persons who: (1) were hospitalized within 30 days of COVID-19 diagnosis (n = 88,405); (2) were admitted to the intensive care unit (ICU)/received mechanical ventilation during COVID-19 hospitalization (n = 22,147); and (3) died during COVID-19 hospitalization (n = 2300)-were matched 1:1 using demographic/clinical factors with controls randomly selected from a pool of patients who did not experience the case definition/event. Medication use was based on prescription ≤90 days before COVID-19 diagnosis.

Results

Statin use was associated with decreased risk of hospitalization (adjusted odds ratio [aOR], 0.72; 95% confidence interval [95% CI], 0.69, 0.75) and ICU admission/mechanical ventilation (aOR, 0.90; 95% CI, 0.84, 0.97). ACEI/ARB use was associated with decreased risk of hospitalization (aOR, 0.67; 95% CI, 0.65, 0.70), ICU admission/mechanical ventilation (aOR, 0.92; 95% CI, 0.86, 0.99), and death (aOR, 0.60; 95% CI, 0.47, 0.78). Anticoagulant use was associated with decreased risk of hospitalization (aOR, 0.94; 95% CI, 0.89, 0.99) and death (aOR, 0.56; 95% CI, 0.41, 0.77). Interaction effects-in the model predicting hospitalization-were statistically significant for statins and ACEI/ARBs (P < .0001), statins and anticoagulants (P = .003), ACEI/ARBs and anticoagulants (P < .0001). An interaction effect-in the model predicting ventilator use/ICU-was statistically significant for statins and ACEI/ARBs (P = .002).

Conclusions

Statins, ACEI/ARBs, and anticoagulants were associated with decreased risks of the adverse outcomes under study. These findings may provide clinically relevant information regarding potential treatment for patients with COVID-19.