Evidence map›Paper›PMID 32757246›Full record

ReviewClinical cardiology2020

Association of angiotensin converting enzyme inhibitors and angiotensin II receptor blockers with risk of COVID-19, inflammation level, severity, and death in patients with COVID-19: A rapid systematic review and meta-analysis.

Xiao Liu, Chuyan Long, Qinmei Xiong, Chen Chen, Jianyong Ma, Yuhao Su, Kui Hong

Open access · goldAbstract readReview
PubMed Full text at PMC Publisher
In one paragraph

Review in Clinical cardiology, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 47 papers, 13 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
47citing papers in PubMed, 13 pooled it
1.7field-weighted citation impact, top 9% 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

47 citing papers in PubMed, 13 syntheses or guidelines pooled it, 70 citations in OpenAlex.

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  17. Potential use of renin-angiotensin-aldosterone system inhibitors to reduce COVID-19 severity.Revista portuguesa de cardiologia : orgao oficial da Sociedade Portuguesa de Cardiologia = Portuguese journal of cardiology : an official journal of the Portuguese Society of Cardiology · 2023
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4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

7 authors at 1 institution in 1 country.

Xiao LiuDepartment of cardiovascular medicine, The Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China.ORCID https://orcid.org/0000-0002-5570-289X
Chuyan LongDepartment of cardiovascular medicine, The Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China.
Qinmei XiongDepartment of cardiovascular medicine, The Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China.
Chen ChenDepartment of cardiovascular medicine, The Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China.
Jianyong MaDepartment of cardiovascular medicine, The Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China.
Yuhao SuDepartment of cardiovascular medicine, The Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China.
Kui HongDepartment of cardiovascular medicine, The Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China.ORCID https://orcid.org/0000-0001-9416-0862
Nanchang University · CN

Funding

National Natural Science Foundation of China 81530013;81600243Postgraduate Innovation Foundation of Jiangxi Province CX-2017198Scientific and Technical Innovation Group of Jiangxi Province 20181BCB24012
6 · The paper itself

Abstract

An association among the use of angiotensin converting enzyme (ACE) inhibitors and angiotensin-receptor blockers (ARBs) with the clinical outcomes of coronavirus disease 2019 (COVID-19) is unclear. PubMed, EMBASE, MedRxiv, and BioRxiv were searched for relevant studies that assessed the association between application of ACEI/ARB and risk of COVID-19, inflammation level, severity COVID-19 infection, and death in patients with COVID-19. Eleven studies were included with 33 483 patients. ACEI/ARB therapy might be associated with the reduced inflammatory factor (interleukin-6) and elevated immune cells counts (CD3, CD8). Meta-analysis showed no significant increase in the risk of COVID-19 infection (odds ratio [OR]: 0.95, 95%CI: 0.89-1.05) in patients receiving ACEI/ARB therapy, and ACEI/ARB therapy was associated with a decreased risk of severe COVID-19 (OR: 0.75, 95%CI: 0.59-0.96) and mortality (OR: 0.52, 95%CI: 0.35-0.79). Subgroup analyses showed among the general population, ACEI/ARB therapy was associated with reduced severe COVID-19 infection (OR: 0.79, 95%CI: 0.60-1.05) and all-cause mortality (OR: 0.31, 95%CI: 0.13-0.75), and COVID-19 infection (OR: 0.85, 95% CI: 0.66-1.08) were not increased. Among patients with hypertension, the use of an ACEI/ARB was associated with a lower severity of COVID-19 (OR: 0.73, 95%CI: 0.51-1.03) and lower mortality (OR: 0.57, 95%CI: 0.37-0.87), without evidence of an increased risk of COVID-19 infection (OR: 1.00). On the basis of the available evidence, ACEI/ARB therapy should be continued in patients who are at risk for, or have COVID-19, either in general population or hypertension patients. Our results need to be interpreted with caution considering the potential for residual confounders, and more well-designed studies that control the clinical confounders are necessary to confirm our findings.

Indexed as

ACEI/ARBCOVID-19hypertensioninfectious diseaselungpneumoniaSARS-COV-2

Identifiers

PMID32757246
PMCPMC7436520
OpenAlexW3047375053

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.