Association of Renin Angiotensin Aldosterone System Inhibitors and Outcomes of Hospitalized Patients with COVID-19

Society of Critical Care Medicine Discovery Viral Infection and Respiratory Illness Universal Study (VIRUS): COVID-19 Registry Investigator Group

doi:10.1097/CCM.0000000000005627

Association of Renin Angiotensin Aldosterone System Inhibitors and Outcomes of Hospitalized Patients with COVID-19

Society of Critical Care Medicine Discovery Viral Infection and Respiratory Illness Universal Study (VIRUS): COVID-19 Registry Investigator Group

Research output: Contribution to journal › Article › peer-review

1 Scopus citations

Abstract

OBJECTIVES: To determine the association of prior use of renin-angiotensin-aldosterone system inhibitors (RAASIs) with mortality and outcomes in hospitalized patients with COVID-19. DESIGN: Retrospective observational study. SETTING: Multicenter, international COVID-19 registry. SUBJECTS: Adult hospitalized COVID-19 patients on antihypertensive agents (AHAs) prior to admission, admitted from March 31, 2020, to March 10, 2021. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: Data were compared between three groups: patients on RAASIs only, other AHAs only, and those on both medications. Multivariable logistic and linear regressions were performed after controlling for prehospitalization characteristics to estimate the effect of RAASIs on mortality and other outcomes during hospitalization. Of 26,652 patients, 7,975 patients were on AHAs prior to hospitalization. Of these, 1,542 patients (19.3%) were on RAASIs only, 3,765 patients (47.2%) were on other AHAs only, and 2,668 (33.5%) patients were on both medications. Compared with those taking other AHAs only, patients on RAASIs only were younger (mean age 63.3 vs 66.9 yr; p < 0.0001), more often male (58.2% vs 52.4%; p = 0.0001) and more often White (55.1% vs 47.2%; p < 0.0001). After adjusting for age, gender, race, location, and comorbidities, patients on combination of RAASIs and other AHAs had higher in-hospital mortality than those on RAASIs only (odds ratio [OR] = 1.28; 95% CI [1.19-1.38]; p < 0.0001) and higher mortality than those on other AHAs only (OR = 1.09; 95% CI [1.03-1.15]; p = 0.0017). Patients on RAASIs only had lower mortality than those on other AHAs only (OR = 0.87; 95% CI [0.81-0.94]; p = 0.0003). Patients on ACEIs only had higher mortality compared with those on ARBs only (OR = 1.37; 95% CI [1.20-1.56]; p < 0.0001). CONCLUSIONS: Among patients hospitalized for COVID-19 who were taking AHAs, prior use of a combination of RAASIs and other AHAs was associated with higher in-hospital mortality than the use of RAASIs alone. When compared with ARBs, ACEIs were associated with signifcantly higher mortality in hospitalized COVID-19 patients.

Original language	English
Pages (from-to)	E744-E758
Journal	Critical care medicine
Volume	50
Issue number	10
DOIs	https://doi.org/10.1097/CCM.0000000000005627
State	Published - Oct 1 2022

Keywords

COVID-19
antihypertensive agents
mortality
outcome
renin-angiotensin-aldosterone system inhibitors

Access to Document

10.1097/CCM.0000000000005627

Cite this

@article{6705f0ccf7e243a384e32b2b0f1d6031,

title = "Association of Renin Angiotensin Aldosterone System Inhibitors and Outcomes of Hospitalized Patients with COVID-19",

abstract = "OBJECTIVES: To determine the association of prior use of renin-angiotensin-aldosterone system inhibitors (RAASIs) with mortality and outcomes in hospitalized patients with COVID-19. DESIGN: Retrospective observational study. SETTING: Multicenter, international COVID-19 registry. SUBJECTS: Adult hospitalized COVID-19 patients on antihypertensive agents (AHAs) prior to admission, admitted from March 31, 2020, to March 10, 2021. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: Data were compared between three groups: patients on RAASIs only, other AHAs only, and those on both medications. Multivariable logistic and linear regressions were performed after controlling for prehospitalization characteristics to estimate the effect of RAASIs on mortality and other outcomes during hospitalization. Of 26,652 patients, 7,975 patients were on AHAs prior to hospitalization. Of these, 1,542 patients (19.3%) were on RAASIs only, 3,765 patients (47.2%) were on other AHAs only, and 2,668 (33.5%) patients were on both medications. Compared with those taking other AHAs only, patients on RAASIs only were younger (mean age 63.3 vs 66.9 yr; p < 0.0001), more often male (58.2% vs 52.4%; p = 0.0001) and more often White (55.1% vs 47.2%; p < 0.0001). After adjusting for age, gender, race, location, and comorbidities, patients on combination of RAASIs and other AHAs had higher in-hospital mortality than those on RAASIs only (odds ratio [OR] = 1.28; 95% CI [1.19-1.38]; p < 0.0001) and higher mortality than those on other AHAs only (OR = 1.09; 95% CI [1.03-1.15]; p = 0.0017). Patients on RAASIs only had lower mortality than those on other AHAs only (OR = 0.87; 95% CI [0.81-0.94]; p = 0.0003). Patients on ACEIs only had higher mortality compared with those on ARBs only (OR = 1.37; 95% CI [1.20-1.56]; p < 0.0001). CONCLUSIONS: Among patients hospitalized for COVID-19 who were taking AHAs, prior use of a combination of RAASIs and other AHAs was associated with higher in-hospital mortality than the use of RAASIs alone. When compared with ARBs, ACEIs were associated with signifcantly higher mortality in hospitalized COVID-19 patients.",

keywords = "COVID-19, antihypertensive agents, mortality, outcome, renin-angiotensin-aldosterone system inhibitors",

author = "{Society of Critical Care Medicine Discovery Viral Infection and Respiratory Illness Universal Study (VIRUS): COVID-19 Registry Investigator Group} and Neha Gupta and Lisa Settle and Brown, {Brent R.} and Armaignac, {Donna L.} and Michael Baram and Perkins, {Nicholas E.} and Margit Kaufman and Melamed, {Roman R.} and Christie, {Amy B.} and Danesh, {Valerie C.} and Denson, {Joshua L.} and Cheruku, {Sreekanth R.} and Karen Boman and Kumar, {Vishakha K.} and Vikas Bansal and Rahul Kashyap and Walkey, {Allan J.} and Domecq, {Juan P.} and Aston, {Christopher E.} and Mesland, {Jean Baptiste} and Pierre Henin and H{\'e}l{\`e}ne Petre and Isabelle Buelens and Gerard, {Anne Catherine} and Philippe Clevenbergh and Granado, {Rolando Claure Del} and Mercado, {Jose A.} and Esdenka Vega-Terrazas and Iturricha-Caceres, {Maria F.} and Ruben Garza and Eric Chu and Victoria Chan and Gavidia, {Oscar Y.} and Felipe Pachon and Sanchez, {Yeimy A.} and Danijel Kne{\v z}evi{\'c} and {El Kassas}, Mohamed and Mohamed Badr and Ahmed Tawheed and Hend Yahia and Dimitrios Kantas and Vasileios Koulouras and Estela Pineda and {Reyes Guillen}, {Gabina Mar{\'i}a} and Soto, {Helin Archaga} and {Vallecillo Lizardo}, {Ana Karen} and Csaba Kopitk{\'o} and {\'A}gnes Bencze and Istv{\'a}n M{\'e}h{\'e}sz and Zs{\'o}fa Gerendai and Phaneendra Doddaga and Neethi Chandra and Segu, {Smitha S.} and Tuhin Chakraborty and Epcebha Joyce and Girish Vadgaonkar and Rekha Ediga and Shilpa Basety and Shwetha Dammareddy and Kasumalla, {Phani Sreeharsha} and Umamaheswara Raju and Janaki Manduva and Naresh Kolakani and Shreeja Sripathi and Sheetal Chaitanya and Anusha Cherian and Sreejith Parameswaran and Magesh Parthiban and {Menu Priya}, A. and Madhav Prabhu and Vishal Jakati and Puneet Rijhwani and Ashish Jain and Aviral Gupta and Jaiswal, {Ram Mohan} and Ambika Tyagi and Nimish Mathur and Daga, {Mradul Kumar} and Munisha Agarwal and Ishan Rohtagi and Sridhar Papani and Mahesh Kamuram and Agrawal, {Kamlesh Kumar} and Vijendra Baghel and Patel, {Kirti Kumar} and Mohan, {Surapaneni Krishna} and Ekambaram Jyothisree and Mukur Petrolwala and Bharat Ladva and Nooshin Dalili and Mohsen Nafa and Wataru Matsuda and Michihito Kyo and Shu Tahara and Mineji Hayakawa and Kunihiko Maekawa and Reina Suzuki and Masamitsu Sanui and Sho Horikita and Yuki Itagaki and Akira Kodate and Yuki Takahashi and Koyo Moriki and Takuya Shiga and Yudai Iwasaki and Hidenobu Shigemitsu and Yuka Mishima and Nobuyuki Nosaka and Michio Nagashima and Abdulrahman Al-Fares and Ulloa, {Mariana Janeth Hermosillo} and Rene Rodriguez-Gutierrez and Gonzalez, {Jose Gerardo Gonzalez} and Alejandro Salcido-Montenegro and Adrian Camacho-Ortiz and Fatimah Hassan-Hanga and Hadiza Galadanci and Gezawa, {Abubakar Shehu} and Kabara, {Halima M.S.} and Amole, {Taiwo Gboluwaga} and Halima Kabir and Haliru, {Dalha Gwarzo} and Ibrahim, {Abdullahi S.} and Asghar, {Muhammad Sohaib} and Mashaal Syed and Naqvi, {Syed Anosh Ali} and Zabolotskikh, {Igor Borisovich} and Zybin, {Konstantin Dmitrievich} and Sinkov, {Sergey Vasilevich} and Musaeva, {Tatiana Sergeevna} and Alamoudi, {Razan K.} and AlSharif, {Hassan M.} and Almazwaghi, {Sarah A.} and Elsakran, {Mohammed S.} and Aid, {Mohamed A.} and Darwich, {Mouaz A.} and Hagag, {Omnia M.} and Ali, {Salah A.} and Alona Rocacorba and Kathrine Supe{\~n}a and Juane, {Efren Ray} and Jenalyn Medina and Jowany Baduria and Amer, {Marwa Ridha} and Bawazeer, {Mohammed Abdullah} and Dahhan, {Talal I.} and Eiad Kseibi and Butt, {Abid Shahzad} and Khurshid, {Syed Moazzum} and Muath Rabee and Mohammed Abujazar and Razan Alghunaim and Maal Abualkhair and AlFirm, {Abeer Turki} and Arabi, {Yaseen M.} and Abdukahil, {Sheryl Ann} and Almazyad, {Mohammed A.} and Alarif, {Mohammed I.} and MacArambon, {Jara M.} and Bukhari, {Ahmad Abdullah} and Albahrani, {Hussain A.} and Asfna, {Kazi N.} and Aldossary, {Kaltham M.} and Marija Zdravkovic and Zoran Todorovic and Viseslav Popadic and Slobodan Klasnja and Ana Andrijevic and Srdjan Gavrilovic and Vladimir Carapic and Bojan Kovacevic and Jovana Bojicic and Pedja Kovacevic and Stevanovic Predrag and Stojakov, {Dejan S.} and Ignjatovic, {Duska K.} and Bojic, {Suzana C.} and Bobos, {Marina M.} and Nenadic, {Irina B.} and Zaric, {Milica S.} and Djuric, {Marko D.} and Djukic, {Vladimir R.} and Teruel, {Santiago Y.} and Martin, {Belen C.} and Uluhan Sili and Huseyin Bilgin and Pinar Ay and Gharpure, {Varsha P.} and Usman Raheemi and Dodd, {Kenneth W.} and Nicholas Goodmanson and Kathleen Hesse and Paige Bird and Chauncey Weinert and Nathan Schoenrade and Abdulrahman Altaher and John Lin and Lyons, {Patrick G.} and Michelson, {Andrew P.} and Nguyen, {Nguyet M.}",

year = "2022",

month = oct,

day = "1",

doi = "10.1097/CCM.0000000000005627",

language = "English",

volume = "50",

pages = "E744--E758",

journal = "Critical care medicine",

issn = "0090-3493",

number = "10",

}

Society of Critical Care Medicine Discovery Viral Infection and Respiratory Illness Universal Study (VIRUS): COVID-19 Registry Investigator Group 2022, 'Association of Renin Angiotensin Aldosterone System Inhibitors and Outcomes of Hospitalized Patients with COVID-19', Critical care medicine, vol. 50, no. 10, pp. E744-E758. https://doi.org/10.1097/CCM.0000000000005627

Association of Renin Angiotensin Aldosterone System Inhibitors and Outcomes of Hospitalized Patients with COVID-19. / Society of Critical Care Medicine Discovery Viral Infection and Respiratory Illness Universal Study (VIRUS): COVID-19 Registry Investigator Group.
In: Critical care medicine, Vol. 50, No. 10, 01.10.2022, p. E744-E758.

Research output: Contribution to journal › Article › peer-review

TY - JOUR

T1 - Association of Renin Angiotensin Aldosterone System Inhibitors and Outcomes of Hospitalized Patients with COVID-19

AU - Society of Critical Care Medicine Discovery Viral Infection and Respiratory Illness Universal Study (VIRUS): COVID-19 Registry Investigator Group

AU - Gupta, Neha

AU - Settle, Lisa

AU - Brown, Brent R.

AU - Armaignac, Donna L.

AU - Baram, Michael

AU - Perkins, Nicholas E.

AU - Kaufman, Margit

AU - Melamed, Roman R.

AU - Christie, Amy B.

AU - Danesh, Valerie C.

AU - Denson, Joshua L.

AU - Cheruku, Sreekanth R.

AU - Boman, Karen

AU - Kumar, Vishakha K.

AU - Bansal, Vikas

AU - Kashyap, Rahul

AU - Walkey, Allan J.

AU - Domecq, Juan P.

AU - Aston, Christopher E.

AU - Mesland, Jean Baptiste

AU - Henin, Pierre

AU - Petre, Hélène

AU - Buelens, Isabelle

AU - Gerard, Anne Catherine

AU - Clevenbergh, Philippe

AU - Granado, Rolando Claure Del

AU - Mercado, Jose A.

AU - Vega-Terrazas, Esdenka

AU - Iturricha-Caceres, Maria F.

AU - Garza, Ruben

AU - Chu, Eric

AU - Chan, Victoria

AU - Gavidia, Oscar Y.

AU - Pachon, Felipe

AU - Sanchez, Yeimy A.

AU - Knežević, Danijel

AU - El Kassas, Mohamed

AU - Badr, Mohamed

AU - Tawheed, Ahmed

AU - Yahia, Hend

AU - Kantas, Dimitrios

AU - Koulouras, Vasileios

AU - Pineda, Estela

AU - Reyes Guillen, Gabina María

AU - Soto, Helin Archaga

AU - Vallecillo Lizardo, Ana Karen

AU - Kopitkó, Csaba

AU - Bencze, Ágnes

AU - Méhész, István

AU - Gerendai, Zsófa

AU - Doddaga, Phaneendra

AU - Chandra, Neethi

AU - Segu, Smitha S.

AU - Chakraborty, Tuhin

AU - Joyce, Epcebha

AU - Vadgaonkar, Girish

AU - Ediga, Rekha

AU - Basety, Shilpa

AU - Dammareddy, Shwetha

AU - Kasumalla, Phani Sreeharsha

AU - Raju, Umamaheswara

AU - Manduva, Janaki

AU - Kolakani, Naresh

AU - Sripathi, Shreeja

AU - Chaitanya, Sheetal

AU - Cherian, Anusha

AU - Parameswaran, Sreejith

AU - Parthiban, Magesh

AU - Menu Priya, A.

AU - Prabhu, Madhav

AU - Jakati, Vishal

AU - Rijhwani, Puneet

AU - Jain, Ashish

AU - Gupta, Aviral

AU - Jaiswal, Ram Mohan

AU - Tyagi, Ambika

AU - Mathur, Nimish

AU - Daga, Mradul Kumar

AU - Agarwal, Munisha

AU - Rohtagi, Ishan

AU - Papani, Sridhar

AU - Kamuram, Mahesh

AU - Agrawal, Kamlesh Kumar

AU - Baghel, Vijendra

AU - Patel, Kirti Kumar

AU - Mohan, Surapaneni Krishna

AU - Jyothisree, Ekambaram

AU - Petrolwala, Mukur

AU - Ladva, Bharat

AU - Dalili, Nooshin

AU - Nafa, Mohsen

AU - Matsuda, Wataru

AU - Kyo, Michihito

AU - Tahara, Shu

AU - Hayakawa, Mineji

AU - Maekawa, Kunihiko

AU - Suzuki, Reina

AU - Sanui, Masamitsu

AU - Horikita, Sho

AU - Itagaki, Yuki

AU - Kodate, Akira

AU - Takahashi, Yuki

AU - Moriki, Koyo

AU - Shiga, Takuya

AU - Iwasaki, Yudai

AU - Shigemitsu, Hidenobu

AU - Mishima, Yuka

AU - Nosaka, Nobuyuki

AU - Nagashima, Michio

AU - Al-Fares, Abdulrahman

AU - Ulloa, Mariana Janeth Hermosillo

AU - Rodriguez-Gutierrez, Rene

AU - Gonzalez, Jose Gerardo Gonzalez

AU - Salcido-Montenegro, Alejandro

AU - Camacho-Ortiz, Adrian

AU - Hassan-Hanga, Fatimah

AU - Galadanci, Hadiza

AU - Gezawa, Abubakar Shehu

AU - Kabara, Halima M.S.

AU - Amole, Taiwo Gboluwaga

AU - Kabir, Halima

AU - Haliru, Dalha Gwarzo

AU - Ibrahim, Abdullahi S.

AU - Asghar, Muhammad Sohaib

AU - Syed, Mashaal

AU - Naqvi, Syed Anosh Ali

AU - Zabolotskikh, Igor Borisovich

AU - Zybin, Konstantin Dmitrievich

AU - Sinkov, Sergey Vasilevich

AU - Musaeva, Tatiana Sergeevna

AU - Alamoudi, Razan K.

AU - AlSharif, Hassan M.

AU - Almazwaghi, Sarah A.

AU - Elsakran, Mohammed S.

AU - Aid, Mohamed A.

AU - Darwich, Mouaz A.

AU - Hagag, Omnia M.

AU - Ali, Salah A.

AU - Rocacorba, Alona

AU - Supeña, Kathrine

AU - Juane, Efren Ray

AU - Medina, Jenalyn

AU - Baduria, Jowany

AU - Amer, Marwa Ridha

AU - Bawazeer, Mohammed Abdullah

AU - Dahhan, Talal I.

AU - Kseibi, Eiad

AU - Butt, Abid Shahzad

AU - Khurshid, Syed Moazzum

AU - Rabee, Muath

AU - Abujazar, Mohammed

AU - Alghunaim, Razan

AU - Abualkhair, Maal

AU - AlFirm, Abeer Turki

AU - Arabi, Yaseen M.

AU - Abdukahil, Sheryl Ann

AU - Almazyad, Mohammed A.

AU - Alarif, Mohammed I.

AU - MacArambon, Jara M.

AU - Bukhari, Ahmad Abdullah

AU - Albahrani, Hussain A.

AU - Asfna, Kazi N.

AU - Aldossary, Kaltham M.

AU - Zdravkovic, Marija

AU - Todorovic, Zoran

AU - Popadic, Viseslav

AU - Klasnja, Slobodan

AU - Andrijevic, Ana

AU - Gavrilovic, Srdjan

AU - Carapic, Vladimir

AU - Kovacevic, Bojan

AU - Bojicic, Jovana

AU - Kovacevic, Pedja

AU - Predrag, Stevanovic

AU - Stojakov, Dejan S.

AU - Ignjatovic, Duska K.

AU - Bojic, Suzana C.

AU - Bobos, Marina M.

AU - Nenadic, Irina B.

AU - Zaric, Milica S.

AU - Djuric, Marko D.

AU - Djukic, Vladimir R.

AU - Teruel, Santiago Y.

AU - Martin, Belen C.

AU - Sili, Uluhan

AU - Bilgin, Huseyin

AU - Ay, Pinar

AU - Gharpure, Varsha P.

AU - Raheemi, Usman

AU - Dodd, Kenneth W.

AU - Goodmanson, Nicholas

AU - Hesse, Kathleen

AU - Bird, Paige

AU - Weinert, Chauncey

AU - Schoenrade, Nathan

AU - Altaher, Abdulrahman

AU - Lin, John

AU - Lyons, Patrick G.

AU - Michelson, Andrew P.

AU - Nguyen, Nguyet M.

PY - 2022/10/1

Y1 - 2022/10/1

N2 - OBJECTIVES: To determine the association of prior use of renin-angiotensin-aldosterone system inhibitors (RAASIs) with mortality and outcomes in hospitalized patients with COVID-19. DESIGN: Retrospective observational study. SETTING: Multicenter, international COVID-19 registry. SUBJECTS: Adult hospitalized COVID-19 patients on antihypertensive agents (AHAs) prior to admission, admitted from March 31, 2020, to March 10, 2021. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: Data were compared between three groups: patients on RAASIs only, other AHAs only, and those on both medications. Multivariable logistic and linear regressions were performed after controlling for prehospitalization characteristics to estimate the effect of RAASIs on mortality and other outcomes during hospitalization. Of 26,652 patients, 7,975 patients were on AHAs prior to hospitalization. Of these, 1,542 patients (19.3%) were on RAASIs only, 3,765 patients (47.2%) were on other AHAs only, and 2,668 (33.5%) patients were on both medications. Compared with those taking other AHAs only, patients on RAASIs only were younger (mean age 63.3 vs 66.9 yr; p < 0.0001), more often male (58.2% vs 52.4%; p = 0.0001) and more often White (55.1% vs 47.2%; p < 0.0001). After adjusting for age, gender, race, location, and comorbidities, patients on combination of RAASIs and other AHAs had higher in-hospital mortality than those on RAASIs only (odds ratio [OR] = 1.28; 95% CI [1.19-1.38]; p < 0.0001) and higher mortality than those on other AHAs only (OR = 1.09; 95% CI [1.03-1.15]; p = 0.0017). Patients on RAASIs only had lower mortality than those on other AHAs only (OR = 0.87; 95% CI [0.81-0.94]; p = 0.0003). Patients on ACEIs only had higher mortality compared with those on ARBs only (OR = 1.37; 95% CI [1.20-1.56]; p < 0.0001). CONCLUSIONS: Among patients hospitalized for COVID-19 who were taking AHAs, prior use of a combination of RAASIs and other AHAs was associated with higher in-hospital mortality than the use of RAASIs alone. When compared with ARBs, ACEIs were associated with signifcantly higher mortality in hospitalized COVID-19 patients.

AB - OBJECTIVES: To determine the association of prior use of renin-angiotensin-aldosterone system inhibitors (RAASIs) with mortality and outcomes in hospitalized patients with COVID-19. DESIGN: Retrospective observational study. SETTING: Multicenter, international COVID-19 registry. SUBJECTS: Adult hospitalized COVID-19 patients on antihypertensive agents (AHAs) prior to admission, admitted from March 31, 2020, to March 10, 2021. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: Data were compared between three groups: patients on RAASIs only, other AHAs only, and those on both medications. Multivariable logistic and linear regressions were performed after controlling for prehospitalization characteristics to estimate the effect of RAASIs on mortality and other outcomes during hospitalization. Of 26,652 patients, 7,975 patients were on AHAs prior to hospitalization. Of these, 1,542 patients (19.3%) were on RAASIs only, 3,765 patients (47.2%) were on other AHAs only, and 2,668 (33.5%) patients were on both medications. Compared with those taking other AHAs only, patients on RAASIs only were younger (mean age 63.3 vs 66.9 yr; p < 0.0001), more often male (58.2% vs 52.4%; p = 0.0001) and more often White (55.1% vs 47.2%; p < 0.0001). After adjusting for age, gender, race, location, and comorbidities, patients on combination of RAASIs and other AHAs had higher in-hospital mortality than those on RAASIs only (odds ratio [OR] = 1.28; 95% CI [1.19-1.38]; p < 0.0001) and higher mortality than those on other AHAs only (OR = 1.09; 95% CI [1.03-1.15]; p = 0.0017). Patients on RAASIs only had lower mortality than those on other AHAs only (OR = 0.87; 95% CI [0.81-0.94]; p = 0.0003). Patients on ACEIs only had higher mortality compared with those on ARBs only (OR = 1.37; 95% CI [1.20-1.56]; p < 0.0001). CONCLUSIONS: Among patients hospitalized for COVID-19 who were taking AHAs, prior use of a combination of RAASIs and other AHAs was associated with higher in-hospital mortality than the use of RAASIs alone. When compared with ARBs, ACEIs were associated with signifcantly higher mortality in hospitalized COVID-19 patients.

KW - COVID-19

KW - antihypertensive agents

KW - mortality

KW - outcome

KW - renin-angiotensin-aldosterone system inhibitors

UR - http://www.scopus.com/inward/record.url?scp=85138445319&partnerID=8YFLogxK

U2 - 10.1097/CCM.0000000000005627

DO - 10.1097/CCM.0000000000005627

M3 - Article

C2 - 35894609

AN - SCOPUS:85138445319

SN - 0090-3493

VL - 50

SP - E744-E758

JO - Critical care medicine

JF - Critical care medicine

IS - 10

ER -

Association of Renin Angiotensin Aldosterone System Inhibitors and Outcomes of Hospitalized Patients with COVID-19

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