Evidence map›Paper›PMID 33404127›Full record

ArticleJournal of medical virology2021

Antihypertensives and their relation to mortality by SARS-CoV-2 infection.

Sandeep Singh, Christine Widrich, Martijn Nap, Emile Schokker, Aeilko H Zwinderman, Sara-Joan Pinto-Sietsma

Abstract read
In one paragraph

Article in Journal of medical virology, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
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

3 citing papers in PubMed.

  1. Article
  2. Observational
  3. Article
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

6 authors.

Sandeep SinghDepartments of Clinical Epidemiology, Biostatistics and Bio-Informatics, Amsterdam University Medical Centre, Academic Medical Center, Amsterdam, The Netherlands.ORCID 0000-0001-9338-1209
Christine WidrichDepartment of Analytics Solutions, IQVIA Nederland, Amsterdam, The Netherlands.
Martijn NapDepartment of Analytics and Technology Solutions, IQVIA Nederland, Amsterdam, The Netherlands.
Emile SchokkerIQVIA, Real World Solutions, Frankfurt, Germany.
Aeilko H ZwindermanDepartments of Clinical Epidemiology, Biostatistics and Bio-Informatics, Amsterdam University Medical Centre, Academic Medical Center, Amsterdam, The Netherlands.
Sara-Joan Pinto-SietsmaDepartments of Clinical Epidemiology, Biostatistics and Bio-Informatics, Amsterdam University Medical Centre, Academic Medical Center, Amsterdam, The Netherlands.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

The role of antihypertensives, especially Renin-Angiotensin-Aldosterone System inhibitors, is still debatable in COVID-19-related severity and outcome. Therefore, we search for a more global analysis of antihypertensive medication in relation to SAS-CoV-2 severity using prescription data worldwide. The association between the percentage use of different types of antihypertensive medications and mortality rates due to a SARS-CoV-2 infection during the first 3 weeks of the pandemic was analyzed using random effects linear regression models for 30 countries worldwide. Higher percentages of prescribed angiotensin receptor blockers (ARBs) (β, 95% confidence interval [CI]; -0.02 [-0.04 to -0.0012]; p = .042) and calcium channel blockers (CCBs) (β, 95% CI; -0.023 [-0.05 to -0.0028]; p = .0304) were associated with a lower first 3-week SARS-CoV-2-related death rate, whereas a higher percentage of prescribed angiotensin-converting enzyme inhibitors (ACEis) (β, 95% CI; 0.03 [0.0061-0.05]; p = .0103) was associated with a higher first 3-week death rate, even when adjusted for age and metformin use. There was no association between the amount of prescribed beta-blockers (BBs) and diuretics (Diu) and the first 3-week death rate. When analyzing the combination of drugs that is used by at least 50% of antihypertensive users, within the different countries, countries with the lowest first 3-week death rates had at least an angiotensin receptor blocker as one of the most often prescribed antihypertensive medications (ARBs/CCBs: [β, 95% CI; -0.02 [-0.03 to -0.004]; p = .009], ARBs/BBs: [β, 95% CI; -0.03 [-0.05 to -0.006]; p = .01]). Finally, countries prescribing high-potency ARBs had lower first 3-week ARBs. In conclusion, ARBs and CCB seem to have a protective effect against death from SARS-CoV-2 infection.

Indexed as

COVID-19 Drug TreatmentAngiotensin-Converting Enzyme InhibitorsAngiotensin Receptor AntagonistsAntihypertensive AgentsCOVID-19HumansHypertensionLinear ModelsMortalityRenin-Angiotensin SystemSARS-CoV-2Severity of Illness IndexAngiotensin-Converting Enzyme InhibitorsAngiotensin Receptor AntagonistsAntihypertensive Agentsangiotensin-converting enzyme inhibitorangiotensin receptor blockersCVOID-19RAAS blockersSARS-CoV-2

Identifiers

PMID33404127
PMCPMC7986392

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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.