Evidence map›Paper›PMID 33722197›Full record

ArticleBMC infectious diseases2021

Renin-angiotensin system inhibitors and susceptibility to COVID-19 in patients with hypertension: a propensity score-matched cohort study in primary care.

Shamil Haroon, Anuradhaa Subramanian, Jennifer Cooper, Astha Anand, Krishna Gokhale, Nathan Byne, Samir Dhalla, Dionisio Acosta-Mena, Thomas Taverner, Kelvin Okoth and 10 more

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

Article in BMC infectious diseases, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
8citing papers in PubMed, 1 pooled it
0.7field-weighted citation impact, top 27% 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

8 citing papers in PubMed, 1 synthesis or guideline pooled it, 12 citations in OpenAlex.

  1. Pooled it
  2. Trial
  3. Article
  4. Review
  5. Review
  6. Review
  7. Nonsteroidal Antiinflammatory Drugs and Susceptibility to COVID-19.Arthritis & rheumatology (Hoboken, N.J.) · 2021
    Article
  8. 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

20 authors at 6 institutions in 2 countries.

Shamil Haroon *Institute of Applied Health Research, University of Birmingham, Birmingham, UK.
Anuradhaa Subramanian *Institute of Applied Health Research, University of Birmingham, Birmingham, UK.
Jennifer CooperInstitute of Applied Health Research, University of Birmingham, Birmingham, UK.
Astha AnandInstitute of Applied Health Research, University of Birmingham, Birmingham, UK.
Krishna GokhaleInstitute of Applied Health Research, University of Birmingham, Birmingham, UK.
Nathan ByneCegedim Health Data, Cegedim Rx, London, UK.
Samir DhallaThe Health Improvement Network (THIN), London, UK.
Dionisio Acosta-MenaCegedim Health Data, Cegedim Rx, London, UK.
Thomas TavernerInstitute of Applied Health Research, University of Birmingham, Birmingham, UK.
Kelvin OkothInstitute of Applied Health Research, University of Birmingham, Birmingham, UK.
Jingya WangInstitute of Applied Health Research, University of Birmingham, Birmingham, UK.
Joht Singh ChandanInstitute of Applied Health Research, University of Birmingham, Birmingham, UK.
Christopher SainsburyInstitute of Applied Health Research, University of Birmingham, Birmingham, UK.
Dawit Tefra ZemedikunInstitute of Applied Health Research, University of Birmingham, Birmingham, UK.
G Neil ThomasInstitute of Applied Health Research, University of Birmingham, Birmingham, UK.
Dhruv ParekhBirmingham Acute Care Research Group, Institute of Inflammation and Ageing, University of Birmingham, Birmingham, UK.
Tom MarshallInstitute of Applied Health Research, University of Birmingham, Birmingham, UK.
Elizabeth SapeyBirmingham Acute Care Research Group, Institute of Inflammation and Ageing, University of Birmingham, Birmingham, UK.
Nicola J AdderleyInstitute of Applied Health Research, University of Birmingham, Birmingham, UK. N.J.Adderley@bham.ac.uk.ORCID http://orcid.org/0000-0003-0543-3254
Krishnarajah NirantharakumarInstitute of Applied Health Research, University of Birmingham, Birmingham, UK.
University of Birmingham · GBHealthcare Improvement Scotland · GBNHS Greater Glasgow and Clyde · GBPioneer (United States) · USQueen Elizabeth Hospital Birmingham · GBUniversity Hospitals Birmingham NHS Foundation Trust · GB

Funding

Medical Research Council MC_PC_21015Medical Research Council MR/L008335/1Medical Research Council MR/S003878/1
6 · The paper itself

Abstract

introductionRenin-angiotensin system (RAS) inhibitors have been postulated to influence susceptibility to Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2). This study investigated whether there is an association between their prescription and the incidence of COVID-19 and all-cause mortality.

methodsWe conducted a propensity-score matched cohort study comparing the incidence of COVID-19 among patients with hypertension prescribed angiotensin-converting enzyme I (ACE) inhibitors or angiotensin II type-1 receptor blockers (ARBs) to those treated with calcium channel blockers (CCBs) in a large UK-based primary care database (The Health Improvement Network). We estimated crude incidence rates for confirmed/suspected COVID-19 in each drug exposure group. We used Cox proportional hazards models to produce adjusted hazard ratios for COVID-19. We assessed all-cause mortality as a secondary outcome.

resultsThe incidence rate of COVID-19 among users of ACE inhibitors and CCBs was 9.3 per 1000 person-years (83 of 18,895 users [0.44%]) and 9.5 per 1000 person-years (85 of 18,895 [0.45%]), respectively. The adjusted hazard ratio was 0.92 (95% CI 0.68 to 1.26). The incidence rate among users of ARBs was 15.8 per 1000 person-years (79 out of 10,623 users [0.74%]). The adjusted hazard ratio was 1.38 (95% CI 0.98 to 1.95). There were no significant associations between use of RAS inhibitors and all-cause mortality.

conclusionUse of ACE inhibitors was not associated with the risk of COVID-19 whereas use of ARBs was associated with a statistically non-significant increase compared to the use of CCBs. However, no significant associations were observed between prescription of either ACE inhibitors or ARBs and all-cause mortality.

Indexed as

AdolescentAdultAgedAged, 80 and overAngiotensin-Converting Enzyme InhibitorsAngiotensin Receptor AntagonistsAntihypertensive AgentsCalcium Channel BlockersCohort StudiesCOVID-19FemaleHumansHypertensionIncidenceMaleMiddle AgedAngiotensin-Converting Enzyme InhibitorsAngiotensin Receptor AntagonistsAntihypertensive AgentsCalcium Channel Blockers

Identifiers

PMID33722197
PMCPMC7957446
OpenAlexW3087021416

What OpenQuestion holds

Textmetadata
LicenceCC BY
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.