3.0 Results:
This meta-analysis includes patients from six studies with confirmed
SARS-CoV-2 infection, and compares the outcomes among 423 patients
receiving ACEi/ARB with 1419 patients who did not receive ACEi/ARB. Bean
et al analysed patients who were on ACEi only, and Liu et al, on ARB
only. The other studies did not segregate between patients on either
ACEi or ARB. Hence, we have pooled the data and conducted this
meta-analysis on the combined effect of ACEi/ARB.
The odds for risk of severity of disease was analysed from data
extracted from all the six citations. The data from the study by Bean et
al was included only for the analysis of the effect of ACEi/ARB on the
risk of severity of disease as the odds ratio for this outcome in
patients on ACEi was clearly mentioned in their publication; we could
not include their data on effect on death since this was not reported
separately as an outcome. (20). Similarly, data from the study of Liu et
al (12) did not report on death separately. As such, the odds for death
was analysed from the data extracted from the studies of Yang et al,
Zeng et al, Zhang et al, and Li et al (17,19, 22). The odds for risk for
hospitalisation was analysed from the data extracted from the studies of
Yang et al (19) and Zeng et al (17) only, since the other four studies
did not report on this outcome.
In view of the numerous terminologies used to report various end points
in the six studies include in this analysis, we chose to assess the
effect of ACEi/ARB on the risk of severity of disease. The data on death
in the four studies was homogeneous as was the data on risk for
hospitalisation among the two studies. The baseline characteristics of
the studies are compiled in table 1. [Table 1]
3.1 Effect of use
of ACEi/ARB in patients with COVID-19 on risk of severity of disease
(Figure 2):
There was a 38% statistically non-significant reduction in the odds of
risk of severity of disease in patients with COVID-19 in the ACEi/ARB
group compared to those not on ACEi/ARB (95% CI: 0.31-1.23,
I2=70.36). There was moderate degree of heterogeneity.