Evidence map›Paper›PMID 32485082›Full record

ArticleEuropean journal of heart failure2020

Angiotensin-converting enzyme inhibitors and angiotensin II receptor blockers are not associated with severe COVID-19 infection in a multi-site UK acute hospital trust.

Daniel M Bean, Zeljko Kraljevic, Thomas Searle, Rebecca Bendayan, O'Gallagher Kevin, Andrew Pickles, Amos Folarin, Lukasz Roguski, Kawsar Noor, Anthony Shek and 4 more

Open access · hybridAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in European journal of heart failure, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 147 papers, 25 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
147citing papers in PubMed, 25 pooled it
5.0field-weighted citation impact, top 3% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

147 citing papers in PubMed, 25 syntheses or guidelines pooled it, 205 citations in OpenAlex.

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  7. Safety and Efficacy of Renin-Angiotensin-Aldosterone System Inhibitors in COVID-19 Population.High blood pressure & cardiovascular prevention : the official journal of the Italian Society of Hypertension · 2021
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87 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

14 authors at 6 institutions in 4 countries.

Daniel M BeanDepartment of Biostatistics and Health Informatics, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.
Zeljko KraljevicDepartment of Biostatistics and Health Informatics, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.
Thomas SearleDepartment of Biostatistics and Health Informatics, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.
Rebecca BendayanDepartment of Biostatistics and Health Informatics, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.
O'Gallagher KevinKing's College Hospital NHS Foundation Trust, London, UK.
Andrew PicklesDepartment of Biostatistics and Health Informatics, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.
Amos FolarinDepartment of Biostatistics and Health Informatics, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.
Lukasz RoguskiHealth Data Research UK London, University College London, London, UK.
Kawsar NoorHealth Data Research UK London, University College London, London, UK.
Anthony ShekDepartment of Clinical Neuroscience, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.
Rosita ZakeriKing's College Hospital NHS Foundation Trust, London, UK.
Ajay M ShahKing's College Hospital NHS Foundation Trust, London, UK.
James T H TeoKing's College Hospital NHS Foundation Trust, London, UK.
Richard J B DobsonDepartment of Biostatistics and Health Informatics, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.
King's College London · GBKing's College Hospital NHS Foundation Trust · GBUCL Biomedical Research Centre · GBJoint Research Center · ESSouth London and Maudsley NHS Foundation Trust · GBUniversity of London · GB

Funding

British Heart Foundation CH/1999001/11735Department of HealthMedical Research Council MC_PC_17214Medical Research Council MR/S00310X/1
6 · The paper itself

Abstract

aimsThe SARS-CoV-2 virus binds to the angiotensin-converting enzyme 2 (ACE2) receptor for cell entry. It has been suggested that angiotensin-converting enzyme inhibitors (ACEi) and angiotensin II receptor blockers (ARB), which are commonly used in patients with hypertension or diabetes and may raise tissue ACE2 levels, could increase the risk of severe COVID-19 infection. METHODS AND

resultsWe evaluated this hypothesis in a consecutive cohort of 1200 acute inpatients with COVID-19 at two hospitals with a multi-ethnic catchment population in London (UK). The mean age was 68 ± 17 years (57% male) and 74% of patients had at least one comorbidity. Overall, 415 patients (34.6%) reached the primary endpoint of death or transfer to a critical care unit for organ support within 21 days of symptom onset. A total of 399 patients (33.3%) were taking ACEi or ARB. Patients on ACEi/ARB were significantly older and had more comorbidities. The odds ratio for the primary endpoint in patients on ACEi and ARB, after adjustment for age, sex and co-morbidities, was 0.63 (95% confidence interval 0.47-0.84, P < 0.01).

conclusionsThere was no evidence for increased severity of COVID-19 in hospitalised patients on chronic treatment with ACEi or ARB. A trend towards a beneficial effect of ACEi/ARB requires further evaluation in larger meta-analyses and randomised clinical trials.

Indexed as

BetacoronavirusAgedAngiotensin-Converting Enzyme InhibitorsAngiotensin Receptor AntagonistsComorbidityCoronavirus InfectionsCOVID-19Disease ProgressionFemaleFollow-Up StudiesHeart FailureHumansMalePandemicsPneumonia, ViralSARS-CoV-2Angiotensin-Converting Enzyme InhibitorsAngiotensin Receptor AntagonistsAngiotensin-converting enzyme inhibitorsCOVID-19Disease outcomeHypertension

Identifiers

PMID32485082
PMCPMC7301045
OpenAlexW3030177929

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.