Evidence map›Paper›PMID 33210357›Full record

ArticleJournal of internal medicine2021

ACE inhibitors, angiotensin receptor blockers and endothelial injury in COVID-19.

S Tetlow, A Segiet-Swiecicka, R O'Sullivan, S O'Halloran, K Kalb, C Brathwaite-Shirley, L Alger, A Ankuli, M S Baig, F Catmur and 8 more

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

Article in Journal of internal medicine, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 23 papers, 3 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
23citing papers in PubMed, 3 pooled it
0.8field-weighted citation impact, top 16% 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

23 citing papers in PubMed, 3 syntheses or guidelines pooled it, 35 citations in OpenAlex.

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  12. Arterial Hypertension in Patients with COVID-19 - Neural Network Model.Acta informatica medica : AIM : journal of the Society for Medical Informatics of Bosnia & Herzegovina : casopis Drustva za medicinsku informatiku BiH · 2022
    Article
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  14. Mechanisms of SARS-CoV-2 Infection-Induced Kidney Injury: A Literature Review.Frontiers in cellular and infection microbiology · 2022
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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 4 institutions in 2 countries.

S TetlowFrom the, Department of Acute Medicine, University College Hospital, Bloomsbury, London, UK.ORCID 0000-0002-3110-1125
A Segiet-SwiecickaChair and Department of Experimental and Clinical Physiology, Laboratory of Centre for Preclinical Research, Medical University of Warsaw, Warszawa, Poland.
R O'SullivanDepartment of Critical Care, Lewisham and Greenwich NHS Trust, London, UK.
S O'HalloranDepartment of Critical Care, Lewisham and Greenwich NHS Trust, London, UK.
K KalbDepartment of Critical Care, Lewisham and Greenwich NHS Trust, London, UK.
C Brathwaite-ShirleyDepartment of Critical Care, Lewisham and Greenwich NHS Trust, London, UK.
L AlgerDepartment of Critical Care, Lewisham and Greenwich NHS Trust, London, UK.
A AnkuliDepartment of Critical Care, Lewisham and Greenwich NHS Trust, London, UK.
M S BaigDepartment of Critical Care, Lewisham and Greenwich NHS Trust, London, UK.
F CatmurDepartment of Critical Care, Lewisham and Greenwich NHS Trust, London, UK.
T ChanDepartment of Critical Care, Lewisham and Greenwich NHS Trust, London, UK.
D DudleyDepartment of Critical Care, Lewisham and Greenwich NHS Trust, London, UK.
J FisherDepartment of Critical Care, Lewisham and Greenwich NHS Trust, London, UK.
M U IqbalDepartment of Critical Care, Lewisham and Greenwich NHS Trust, London, UK.
J PuczynskaDepartment of Critical Care, Lewisham and Greenwich NHS Trust, London, UK.
R WilkinsDepartment of Critical Care, Lewisham and Greenwich NHS Trust, London, UK.
R BygateDepartment of Acute Medicine, Newham University Hospital NHS Trust, Newham University Hospital, London, UK.
P RobertsDepartment of Critical Care, Lewisham and Greenwich NHS Trust, London, UK.
Lewisham and Greenwich NHS Trust · GBMedical University of Warsaw · PLNewham University Hospital · GBUniversity College Hospital · GB

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundCOVID-19 is caused by the coronavirus SARS-CoV-2, which uses angiotensin-converting enzyme 2 (ACE-2) as a receptor for cellular entry. It is theorized that ACE inhibitors (ACE-Is) or angiotensin receptor blockers (ARBs) may increase vulnerability to SARS-CoV-2 by upregulating ACE-2 expression, but ACE-I/ARB discontinuation is associated with clinical deterioration.

objectiveTo determine whether ACE-I and ARB use is associated with acute kidney injury (AKI), macrovascular thrombosis and in-hospital mortality.

methodsA retrospective, single-centre study of 558 hospital inpatients with confirmed COVID-19 admitted from 1 March to 30 April 2020, followed up until 24 May 2020. AKI and macrovascular thrombosis were primary end-points, and in-hospital mortality was a secondary end-point.

resultsAKI occurred in 126 (23.1%) patients, 34 (6.1%) developed macrovascular thrombi, and 200 (35.9%) died. Overlap propensity score-weighted analysis showed no significant effect of ACE-I/ARB use on the risk of occurrence of the specified end-points. On exploratory analysis, severe chronic kidney disease (CKD) increases odds of macrovascular thrombi (OR: 8.237, 95% CI: 1.689-40.181, P = 0.009). The risk of AKI increased with advancing age (OR: 1.028, 95% CI: 1.011-1.044, P = 0.001) and diabetes (OR: 1.675, 95% CI: 1.065-2.633, P = 0.025). Immunosuppression was associated with lower risk of AKI (OR: 0.160, 95% CI: 0.029-0.886, P = 0.036). Advancing age, dependence on care, male gender and eGFR < 60 mL min

conclusionWe did not identify an association between ACE-I/ARB use and AKI, macrovascular thrombi or mortality. This supports the recommendations of the European and American Societies of Cardiology that ACE-Is and ARBs should not be discontinued during the COVID-19 pandemic.

Indexed as

Acute Kidney InjuryCOVID-19HypertensionRenal Insufficiency, ChronicThrombosisAgedAge FactorsAngiotensin-Converting Enzyme InhibitorsAngiotensin Receptor AntagonistsComorbidityDiabetes MellitusFemaleGlomerular Filtration RateHospital MortalityHumansMaleAngiotensin-Converting Enzyme InhibitorsAngiotensin Receptor AntagonistsACE inhibitorscritical careendothelial functioninfectious diseaserenal failurethrombosis

Identifiers

PMID33210357
PMCPMC7753609
OpenAlexW3100996285

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.