SynthesisVascular pharmacology2020
RAAS inhibitors are not associated with mortality in COVID-19 patients: Findings from an observational multicenter study in Italy and a meta-analysis of 19 studies.
Synthesis in Vascular pharmacology, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 2 registered trials, which are not on this map. Cited by 32 papers, 3 of them syntheses that pooled 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.
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.
ACE Inhibitors, Angiotensin II Type-I Receptor Blockers and Severity of COVID-19
Long Term Outcomes in COVID-19 Patients Recruited in the CORIST Project: Longitudinal Data and Case-control Study
Who cites it
32 citing papers in PubMed, 3 syntheses or guidelines pooled it, 50 citations in OpenAlex.
- An umbrella review and meta-analysis of renin-angiotensin system drugs use and COVID-19 outcomes.European journal of clinical investigation · 2023Pooled it
- Renin-Angiotensin Aldosterone System Inhibitors and COVID-19: A Systematic Review and Meta-Analysis Revealing Critical Bias Across a Body of Observational Research.Journal of the American Heart Association · 2022Pooled it
- Pooled it
- Efficacy of Losartan in Hospitalized Patients With COVID-19-Induced Lung Injury: A Randomized Clinical Trial.JAMA network open · 2022Trial
- Combined ACEI and ARB therapy and ICU mortality in critically ill COVID-19 patients: a retrospective cohort study.Frontiers in pharmacology · 2026Article
- The Bidirectional Association Between Metabolic Syndrome and Long-COVID-19.Diabetes, metabolic syndrome and obesity : targets and therapy · 2024Review
- Diabetes and COVID-19: The potential role of mTOR.Diabetes research and clinical practice · 2022Review
- Interaction of ACEI antihypertensive agent's administration with the inflammatory status at admission concerning COVID-19 clinical stay outcomes.Vascular pharmacology · 2022Article
- New endemic and pandemic pathologies with interhuman airborne transmission through ear, nose and throat anatomical sites.Acta otorhinolaryngologica Italica : organo ufficiale della Societa italiana di otorinolaringologia e chirurgia cervico-facciale · 2022Article
- Foe and friend in the COVID-19-associated acute kidney injury: an insight on intrarenal renin-angiotensin system.Acta biochimica et biophysica Sinica · 2022Review
- mTOR Inhibitor Use Is Associated With a Favorable Outcome of COVID-19 in Patients of Kidney Transplant: Results of a Retrospective Study.Frontiers in medicine · 2022Article
- SARS-CoV-2 in Kidney Transplant Patients: A Real-Life Experience.Frontiers in medicine · 2022Article
- Early Determinants of Mortality in Hospitalized COVID-19 Patients in the Eastern Province of Saudi Arabia.International journal of general medicine · 2022Article
- Late phase of COVID-19 pandemic in General Cardiology. A position paper of the ESC Council for Cardiology Practice.ESC heart failure · 2021Article
- Characterization of ACE Inhibitors and ATLife (Basel, Switzerland) · 2021Article
- Renin-Angiotensin Aldosterone System Inhibitors in Primary Prevention and COVID-19.Journal of the American Heart Association · 2021Article
- Classical and Counter-Regulatory Renin-Angiotensin System: Potential Key Roles in COVID-19 Pathophysiology.CJC open · 2021Review
- Review
- A comprehensive guide to the pharmacologic regulation of angiotensin converting enzyme 2 (ACE2), the SARS-CoV-2 entry receptor.Pharmacology & therapeutics · 2021Review
- Mortality in Patients with COVID-19 on Renin Angiotensin System Inhibitor Long-Term Treatment: An Observational Study Showing that Things Are Not Always as They Seem.Advances in therapy · 2021Observational
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
1 author at 20 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveThe hypothesis that been set forward that use of Renin Angiotensin Aldosterone System (RAAS) inhibitors is associated with COVID-19 severity. We set-up a multicenter Italian collaboration (CORIST Project, ClinicalTrials.gov ID: NCT04318418) to retrospectively investigate the relationship between RAAS inhibitors and COVID-19 in-hospital mortality. We also carried out an updated meta-analysis on the relevant studies.
methodsWe analyzed 4069 unselected patients with laboratory-confirmed SARS-CoV-2 infection and hospitalized in 34 clinical centers in Italy from February 19, 2020 to May 23, 2020. The primary end-point in a time-to event analysis was in-hospital death, comparing patients who received angiotensin-converting-enzyme inhibitors (ACEI) or angiotensin-receptor blockers (ARB) with patients who did not. Articles for the meta-analysis were retrieved until July 13th, 2020 by searching in web-based libraries, and data were combined using the general variance-based method.
resultsOut of 4069 COVID-19 patients, 13.5% and 13.3% received ACE-I or ARB, respectively. Use of neither ACE-I nor ARB was associated with mortality (multivariable hazard ratio (HR) adjusted also for COVID-19 treatments: 0.96, 95% confidence interval 0.77-1.20 and HR = 0.89, 0.67-1.19 for ACE-I and ARB, respectively). Findings were similar restricting the analysis to hypertensive (N = 2057) patients (HR = 1.00, 0.78-1.26 and HR = 0.88, 0.65-1.20) or when ACE-I or ARB were considered as a single group. Results from the meta-analysis (19 studies, 29,057 COVID-19 adult patients, 9700 with hypertension) confirmed the absence of association.
conclusionsIn this observational study and meta-analysis of the literature, ACE-I or ARB use was not associated with severity or in-hospital mortality in COVID-19 patients.
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Registered trials
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.