Evidence map›Paper›PMID 33138935›Full record

Observational studyJournal of the American Medical Directors Association2020

COVID-19 In-Hospital Mortality and Use of Renin-Angiotensin System Blockers in Geriatrics Patients.

Bastien Genet, Jean-Sébastien Vidal, Adrien Cohen, Clémence Boully, Maëlle Beunardeau, Louise Marine Harlé, Anna Gonçalves, Yasmina Boudali, Intza Hernandorena, Henri Bailly and 8 more

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

Observational study 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 27 papers, 9 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
27citing papers in PubMed, 9 pooled it
0.9field-weighted citation impact, top 15% 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

27 citing papers in PubMed, 9 syntheses or guidelines pooled it, 35 citations in OpenAlex.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

18 authors at 5 institutions in 1 country.

Bastien GenetAssistance Publique-Hôpitaux de Paris, Hôpitaux Universitaires Paris Centre, Hôpital Broca, Service de gériatrie, F-75013, Paris, France.
Jean-Sébastien VidalAssistance Publique-Hôpitaux de Paris, Hôpitaux Universitaires Paris Centre, Hôpital Broca, Service de gériatrie, F-75013, Paris, France; EA 4468, Université de Paris, F-75013, Paris, France.
Adrien CohenAssistance Publique-Hôpitaux de Paris, Hôpitaux Universitaires Paris Centre, Hôpital Broca, Service de gériatrie, F-75013, Paris, France; EA 4468, Université de Paris, F-75013, Paris, France.
Clémence BoullyAssistance Publique-Hôpitaux de Paris, Hôpitaux Universitaires Paris Centre, Hôpital Broca, Service de gériatrie, F-75013, Paris, France; EA 4468, Université de Paris, F-75013, Paris, France.
Maëlle BeunardeauAssistance Publique-Hôpitaux de Paris, Hôpitaux Universitaires Paris Centre, Hôpital Broca, Service de gériatrie, F-75013, Paris, France; EA 4468, Université de Paris, F-75013, Paris, France.
Louise Marine HarléAssistance Publique-Hôpitaux de Paris, Hôpitaux Universitaires Paris Centre, Hôpital Broca, Service de gériatrie, F-75013, Paris, France; EA 4468, Université de Paris, F-75013, Paris, France.
Anna GonçalvesAssistance Publique-Hôpitaux de Paris, Hôpitaux Universitaires Paris Centre, Hôpital Broca, Service de gériatrie, F-75013, Paris, France; EA 4468, Université de Paris, F-75013, Paris, France.
Yasmina BoudaliAssistance Publique-Hôpitaux de Paris, Hôpitaux Universitaires Paris Centre, Hôpital Broca, Service de gériatrie, F-75013, Paris, France; EA 4468, Université de Paris, F-75013, Paris, France.
Intza HernandorenaAssistance Publique-Hôpitaux de Paris, Hôpitaux Universitaires Paris Centre, Hôpital Broca, Service de gériatrie, F-75013, Paris, France; EA 4468, Université de Paris, F-75013, Paris, France.
Henri BaillyAssistance Publique-Hôpitaux de Paris, Hôpitaux Universitaires Paris Centre, Hôpital Broca, Service de gériatrie, F-75013, Paris, France; EA 4468, Université de Paris, F-75013, Paris, France.
Hermine LenoirAssistance Publique-Hôpitaux de Paris, Hôpitaux Universitaires Paris Centre, Hôpital Broca, Service de gériatrie, F-75013, Paris, France; EA 4468, Université de Paris, F-75013, Paris, France.
Matthieu PiccoliAssistance Publique-Hôpitaux de Paris, Hôpitaux Universitaires Paris Centre, Hôpital Broca, Service de gériatrie, F-75013, Paris, France; EA 4468, Université de Paris, F-75013, Paris, France.
Anne ChahwakilianAssistance Publique-Hôpitaux de Paris, Hôpitaux Universitaires Paris Centre, Hôpital Broca, Service de gériatrie, F-75013, Paris, France; EA 4468, Université de Paris, F-75013, Paris, France.
Léna KermanachAssistance Publique-Hôpitaux de Paris, Hôpitaux Universitaires Paris Centre, Hôpital Broca, Service de gériatrie, F-75013, Paris, France; EA 4468, Université de Paris, F-75013, Paris, France.
Laura de JongCentre Hospitalier Sainte-Anne, GHU Paris Psychiatrie & Neurosciences, F-75014, Paris, France.
Emmanuelle DuronAssistance Publique-Hôpitaux de Paris, Hôpital Paul Brousse, Service de gériatrie, F-94804, Villejuif, France; Université Paris-Sud XI, F-94270, Le Kremlin-Bicêtre, France.
Xavier GirerdFondation de recherche sur l'hypertension artérielle (FRHTA), F-75013, Paris, France; Assistance Publique-Hôpitaux de Paris, Hôpital Pitié Salpêtrière, Sorbonne Université, F-75013, Paris, France.
Olivier HanonAssistance Publique-Hôpitaux de Paris, Hôpitaux Universitaires Paris Centre, Hôpital Broca, Service de gériatrie, F-75013, Paris, France; EA 4468, Université de Paris, F-75013, Paris, France. Electronic address: olivier.hanon@brc.aphp.fr.
Université Paris Cité · FRAssistance Publique – Hôpitaux de Paris · FRCentre Hospitalier Sainte-Anne · FRSorbonne Université · FRUniversité Paris-Sud · FR

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveThe role of treatment with renin-angiotensin-aldosterone system blockers at the onset of COVID-19 infection is not known in the geriatric population. The aim of this study was to assess the relationship between angiotensin receptor blockers (ARBs) and angiotensin-converting enzyme inhibitor (ACEI) use and in-hospital mortality in geriatric patients hospitalized for COVID-19.

designThis observational retrospective study was conducted in a French geriatric department. Patients were included between March 17 and April 18, 2020. SETTING AND

participantsAll consecutive 201 patients hospitalized for COVID-19 (confirmed by reverse-transcriptase polymerase chain reaction methods) were included. All nondeceased patients had 30 days of follow-up and no patient was lost to follow-up.

methodsDemographic, clinical, and biological data and medications were collected. In-hospital mortality of patients treated or not by ACEI/ARB was analyzed using multivariate Cox models.

resultsMean age of the population was 86.3 (8.0) years, 62.7% of patients were institutionalized, 88.6% had dementia, and 53.5% had severe disability (activities of daily living [ADL] score <2). Sixty-three patients were treated with ACEI/ARB and 138 were not. Mean follow-up was 23.4 (10.0) days, 66 (33.8%) patients died after an average of 10.0 days (6.0). Lower mortality rate was observed in patients treated with ACEI/ARB compared with patients not treated with ARB or ACEI (22.2% [14] vs 37.7% [52], hazard ratio [HR] 0.54; 95% confidence interval 0.30-0.97; P = .03). In a multivariate Cox regression model including age, sex, ADL score, Charlson index, renal function, dyspnea, C-reactive protein, and white blood cell count, use of ACEI/ARB was significantly associated with lower in-hospital mortality (HR 0.52 (0.27-0.99), P = .048). CONCLUSION AND IMPLICATIONS: In very old subjects hospitalized in geriatric settings for COVID-19, mortality was significantly lower in subjects treated with ARB or ACEI before the onset of infection. The continuation of ACEI/ARB therapy should be encouraged during periods of coronavirus outbreak in older subjects.

Indexed as

AgedAged, 80 and overAngiotensin-Converting Enzyme InhibitorsBetacoronavirusCoronavirus InfectionsCOVID-19FemaleFranceGeriatric NursingHospital MortalityHumansMalePandemicsPneumonia, ViralRetrospective StudiesSARS-CoV-2Angiotensin-Converting Enzyme Inhibitorsangiotensin-converting enzyme inhibitorangiotensin receptor blockersCOVID-19geriatricsin-hospital mortalityrenin-angiotensin-aldosterone system blockers

Identifiers

PMID33138935
PMCPMC7480334
OpenAlexW3084138038

What OpenQuestion holds

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Registered trials

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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.