Evidence map›Paper›PMID 33220171›Full record

Observational studyJournal of clinical hypertension (Greenwich, Conn.)2021

Hypertension, medications, and risk of severe COVID-19: A Massachusetts community-based observational study.

Ann Z Bauer, Rebecca Gore, Susan R Sama, Richard Rosiello, Lawrence Garber, Devi Sundaresan, Anne McDonald, Patricia Arruda, David Kriebel

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

Observational study in Journal of clinical hypertension (Greenwich, Conn.), 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 29 papers, 3 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
29citing papers in PubMed, 3 pooled it
0.8field-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

29 citing papers in PubMed, 3 syntheses or guidelines pooled it, 46 citations in OpenAlex.

  1. Pooled it
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  16. A Query Engine for Self-controlled Case Series, with an application to COVID-19 EHR data.AMIA Joint Summits on Translational Science proceedings. AMIA Joint Summits on Translational Science · 2023
    Article
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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

9 authors at 2 institutions in 1 country.

Ann Z BauerDepartment of Public Health, University of Massachusetts Lowell, Lowell, MA, USA.ORCID 0000-0003-4808-2503
Rebecca GoreDepartment of Public Health, University of Massachusetts Lowell, Lowell, MA, USA.
Susan R SamaDepartment of Public Health, University of Massachusetts Lowell, Lowell, MA, USA.
Richard RosielloReliant Medical Group, Inc, Worcester, MA, USA.
Lawrence GarberReliant Medical Group, Inc, Worcester, MA, USA.
Devi SundaresanReliant Medical Group, Inc, Worcester, MA, USA.
Anne McDonaldReliant Medical Group, Inc, Worcester, MA, USA.
Patricia ArrudaReliant Medical Group, Inc, Worcester, MA, USA.
David KriebelDepartment of Public Health, University of Massachusetts Lowell, Lowell, MA, USA.
Reliant Medical Group · USUniversity of Massachusetts Lowell · US

Funding

University of Massachusetts Lowell
6 · The paper itself

Abstract

It remains uncertain whether the hypertension (HT) medications angiotensin-converting enzyme inhibitors (ACEi) and angiotensin receptor blockers (ARB) mitigate or exacerbate SARS-CoV-2 infection. We evaluated the association of ACEi and ARB with severe coronavirus disease 19 (COVID-19) as defined by hospitalization or mortality among individuals diagnosed with COVID-19. We investigated whether these associations were modified by age, the simultaneous use of the diuretic thiazide, and the health conditions associated with medication use. In an observational study utilizing data from a Massachusetts group medical practice, we identified 1449 patients with a COVID-19 diagnosis. In our study, pre-infection comorbidities including HT, cardiovascular disease, and diabetes were associated with increased risk of severe COVID-19. Risk was further elevated in patients under age 65 with these comorbidities or cancer. Twenty percent of those with severe COVID-19 compared to 9% with less severe COVID-19 used ACEi, 8% and 4%, respectively, used ARB. In propensity score-matched analyses, use of neither ACEi (OR = 1.30, 95% CI 0.93 to 1.81) nor ARB (OR = 0.94, 95% CI 0.57 to 1.55) was associated with increased risk of severe COVID-19. Thiazide use did not modify this relationship. Beta blockers, calcium channel blockers, and anticoagulant medications were not associated with COVID-19 severity. In conclusion, cardiovascular-related comorbidities were associated with severe COVID-19 outcomes, especially among patients under age 65. We found no substantial increased risk of severe COVID-19 among patients taking antihypertensive medications. Our findings support recommendations against discontinuing use of renin-angiotensin system (RAS) inhibitors to prevent severe COVID-19.

Indexed as

AdultAgedAged, 80 and overAngiotensin-Converting Enzyme InhibitorsAngiotensin Receptor AntagonistsAntihypertensive AgentsCase-Control StudiesComorbidityCOVID-19FemaleHospitalizationHospital MortalityHumansHypertensionMaleMassachusettsAngiotensin-Converting Enzyme InhibitorsAngiotensin Receptor AntagonistsAntihypertensive AgentsSodium Chloride Symporter Inhibitorsangiotensin-converting enzyme inhibitorsangiotensin receptor blockersCOVID-19hypertensionrenin-angiotensin system

Identifiers

PMID33220171
PMCPMC7753489
OpenAlexW3106757690

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.