Zhang et al.16
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Nine Hospitals in Hubei Province of China
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Recruited total of 3611 patients; Among which 3430 patients were
selected comprising 1128 were hypertensive and 2302 were normotensive
(Hypertensive group had comorbidities like diabetes 21.3%, coronary
heart disease 11.6 %, chronic renal disease 3.1%)
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In the hypertensive group,
188 patients are classified as ACEI/ARB group
940 patients are classified as non-ACEI/ARB group.
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Statistical analysis showed, ACEI/ARB receiving patients had low risk
of COVID-19 mortality than non-ACEI/ARB. (Mixed effect Cox Model:
adjusted HR, 0.42; 95% CI, 0.19-0.92; P =0.03; Propensity score
matched analysis+ mixed effect Cox model: adjusted HR, 0.37; 95% CI,
0.15-0.89; P = 0.03; Subgroup propensity score-matched analysis:
adjusted HR, 0.30; 95% CI, 0.12-0.70; P = 0.01)
Incidence of septic shock was 3.2% in ACEI/ARB group than 8.0 % in
non-ACEI/ARB group
Disseminated intravascular coagulation (DIC) was 0.0 % in ACEI/ARB
group than 2.3 % in non-ACEI/ARB group
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Bean et al.17
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King’s College Hospital and Princess Royal University Hospital, London,
UK
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The cohort study recruited total of 205 patients (51.2% hypertensive,
30.2% diabetic and 14.6% ischemic heart disease or heart
failure)
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37 patients on ACEI and 168 patients on non-ACEI
9 patients on ARB and 196 patients on non-ARB
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Statistical analysis (NLP: Natural language processing; informatics
tools followed by logistic regression applying Firth’s correction)
showed ACE inhibitor reduced risk of rapidly deteriorating COVID-19 (OR,
0.29; 95% CI, 0.10-0.75; P < 0.01 in patients with diabetes
mellitus, ischemic heart disease, heart failure)
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Meng et al.18
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Shenzhen Third People’s Hospital, China
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The study recruited total of 417 patients in which 51 (12.23 %) were
hypertensive. Among which 42 patients met the criteria
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Among 42 patients;
17 patients were categorized in ACEI/ARB group
25 patients were non-ACEI/ARB group.
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The median number of days from the onset of symptoms to hospital
admission was 3.0 in the ACEI/ARB group and 2.0 in the non-ACEI/ARB
group.
ACEI/ARB group of patients had lower IL-6 expression
(<20pg/mL) than non-ACEI/ARB group (>20 pg/mL).
The peak viral load during hospitalization in the ACEI/ARB group was
significantly lower than that in the non-ACEI/ARB group and CD3+ /CD8+
T cells in the ACEI/ARB group was higher than of non-ACEI/ARB group
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Yang et al. 19
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Hubei Provincial Hospital of Traditional Chinese Medicine, China
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Recruited total of 462 patients.
(126 patients (27.2% ) had pre-existing hypertension with 30.2% having
diabetes, 18.3% having cardiopathy and 125 (27.1%) were normotensive
patients
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Among 126 hypertensive group;
43 patients were sub categorized in ACEI/ARB group
83 patients were non-ACEI/ARB group
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Hypertensive patients on ACEI/ARB had a much lower proportion of
critical patients (9.3% vs 22.9%), and a lower death rate (4.7% vs
13.3%) than those on non-ARBs/ACEIs medications
Hypertensive patients on ACEI/ARB had a much lower proportion of
critical patients (9.3% vs 22.9%), and a lower death rate (4.7% vs
13.3%) than those on non-ARBs/ACEIs medications
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Liu et al.20
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1. Shenzhen Third People’s hospital (Shenzhen, China)
2. Renmin Hospital of Wuhan University (Wuhan, China)
3. Fifth Medical Center of People’s Liberation Army General Hospital
(Beijing, China)
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Recruited total of 557 patients.
(Among 511 patients, 78 patients had hypertension comorbidity);
Additional 46 patients were recruited with age >65 yrs.
with premedication history of anti-hypertensive drugs
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78 patients were categorized as six sub groups (ACEI, ARB, CCB, BB,
thiazide and none); 40 patients were categorized as COVID-19 Mild and
38 patients were categorized as COVID-19 Severe
Among 46 patients; 18 were categorized as mild and 28 were categorized
as severe.
Meta-analysis was performed with 70346 ARB patients associated with
pneumonia
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78 patients shows no statistical significance in disease severity
among six sub groups
The risk of 28 patients (COVID-19-severe) was significantly lowered in
ARB medication in comparison to patients who took no drugs (OR=0•343,
95% CI 0•128-0•916, p=0•025).
ARBs were found to be associated with a declined mortality rate for
pneumonia (OR=0•55, 95% CI; 0•44-0•69, p<0•01)
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