Evidence map›Paper›PMID 32674818›Full record

ArticleJournal of the American Medical Directors Association2020

The Effects of ARBs, ACEis, and Statins on Clinical Outcomes of COVID-19 Infection Among Nursing Home Residents.

Anton De Spiegeleer, Antoon Bronselaer, James T Teo, Geert Byttebier, Guy De Tré, Luc Belmans, Richard Dobson, Evelien Wynendaele, Christophe Van De Wiele, Filip Vandaele and 4 more

Open access · bronzeAbstract readMulticenter Study
PubMed Full text at PMC Publisher
In one paragraph

Article in Journal of the American Medical Directors Association, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 116 papers, 19 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
116citing papers in PubMed, 19 pooled it
4.0field-weighted citation impact, top 4% 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

116 citing papers in PubMed, 19 syntheses or guidelines pooled it, 176 citations in OpenAlex.

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  4. The Association Between the Use of Statins and Clinical Outcomes in Patients with COVID-19: A Systematic Review and Meta-analysis.American journal of cardiovascular drugs : drugs, devices, and other interventions · 2022
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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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  8. Statin and outcomes of coronavirus disease 2019 (COVID-19): A systematic review, meta-analysis, and meta-regression.Nutrition, metabolism, and cardiovascular diseases : NMCD · 2021 · on this map
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56 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 3 institutions in 2 countries.

Anton De SpiegeleerDrug Quality and Registration Group, Faculty of Pharmaceutical Sciences, Ghent University, Ghent, Belgium; Department of Geriatrics, Faculty of Medicine and Health Sciences, Ghent University Hospital, Ghent, Belgium; Unit for Molecular Immunology and Inflammation, VIB-Center for Inflammation Research, Ghent, Belgium.
Antoon BronselaerDDCM Laboratory, Department of Telecommunications and Information Processing, Faculty of Engineering and Architecture, Ghent University, Ghent, Belgium.
James T TeoDepartment of Clinical Neuroscience, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.
Geert ByttebierBioconstat BV, Ghent, Belgium.
Guy De TréDDCM Laboratory, Department of Telecommunications and Information Processing, Faculty of Engineering and Architecture, Ghent University, Ghent, Belgium.
Luc BelmansDepartment of Public Health and Primary Care, Faculty of Medicine and Health Sciences, Ghent University Hospital, Ghent, Belgium.
Richard DobsonDepartment of Biostatistics and Health Informatics, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.
Evelien WynendaeleDrug Quality and Registration Group, Faculty of Pharmaceutical Sciences, Ghent University, Ghent, Belgium.
Christophe Van De WieleDepartment of Diagnostic Sciences, Faculty of Medicine and Health Sciences, Ghent University Hospital, Ghent, Belgium.
Filip VandaeleVZW Zorg-Saam Zusters Kindsheid Jesu, Ghent, Belgium.
Diemer Van DijckCorilus Health IT Center, Ghent, Belgium.
Dan BeanDepartment of Biostatistics and Health Informatics, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.
David Fedson57, chemin du Lavoir, Sergy Haut, France.
Bart De SpiegeleerDrug Quality and Registration Group, Faculty of Pharmaceutical Sciences, Ghent University, Ghent, Belgium. Electronic address: bart.despiegeleer@ugent.be.
Ghent University · BEGhent University Hospital · BEKing's College London · GB

Funding

Medical Research Council MC_PC_17214Medical Research Council MR/S00310X/1
6 · The paper itself

Abstract

objectivesAngiotensin-converting enzyme inhibitors (ACEi), angiotensin II receptor blockers (ARBs), and HMG-CoA reductase inhibitors ("statins") have been hypothesized to affect COVID-19 severity. However, up to now, no studies investigating this association have been conducted in the most vulnerable and affected population groups (ie, older adults residing in nursing homes). The objective of this study was to explore the association of ACEi/ARB and/or statins with clinical manifestations in COVID-19-infected older adults residing in nursing homes.

designWe undertook a retrospective multicenter cohort study to analyze the association between ACEi/ARB and/or statin use with clinical outcome of COVID-19. The outcomes were (1) serious COVID-19 defined as long-stay hospital admission or death within 14 days of disease onset, and (2) asymptomatic (ie, no disease symptoms in the whole study period while still being diagnosed by polymerase chain reaction). SETTING AND

participantsA total of 154 COVID-19-positive subjects were identified, residing in 1 of 2 Belgian nursing homes that experienced similar COVID-19 outbreaks. MEASURES: Logistic regression models were applied with age, sex, functional status, diabetes, and hypertension as covariates.

resultsWe found a statistically significant association between statin intake and the absence of symptoms during COVID-19 (odds ratio [OR] 2.91; confidence interval [CI] 1.27-6.71), which remained statistically significant after adjusting for covariates (OR 2.65; CI 1.13-6.68). Although the effects of statin intake on serious clinical outcome were in the same beneficial direction, these were not statistically significant (OR 0.75; CI 0.24-1.87). There was also no statistically significant association between ACEi/ARB and asymptomatic status (OR 2.72; CI 0.59-25.1) or serious clinical outcome (OR 0.48; CI 0.10-1.97). CONCLUSIONS AND IMPLICATIONS: Our data indicate that statin intake in older, frail adults could be associated with a considerable beneficial effect on COVID-19 clinical symptoms. The role of statins and renin-angiotensin system drugs needs to be further explored in larger observational studies as well as randomized clinical trials.

Indexed as

AgedAged, 80 and overAngiotensin-Converting Enzyme InhibitorsAngiotensin Receptor AntagonistsBelgiumCause of DeathCohort StudiesCoronavirus InfectionsCOVID-19FemaleGeriatric AssessmentHomes for the AgedHumansHydroxymethylglutaryl-CoA Reductase InhibitorsLogistic ModelsMaleAngiotensin-Converting Enzyme InhibitorsAngiotensin Receptor AntagonistsHydroxymethylglutaryl-CoA Reductase InhibitorsAngiotensin-converting enzyme inhibitorsangiotensin II receptor blockersCOVID-19nursing home residentsstatins

Identifiers

PMID32674818
PMCPMC7294267
OpenAlexW3034872024

What OpenQuestion holds

Textmetadata
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.