Evidence map›Paper›PMID 34411004›Full record

Observational studyThe Journal of clinical investigation2021

In-hospital use of ACE inhibitors/angiotensin receptor blockers associates with COVID-19 outcomes in African American patients.

Shilong Li, Rangaprasad Sarangarajan, Tomi Jun, Yu-Han Kao, Zichen Wang, Ke Hao, Emilio Schadt, Michael A Kiebish, Elder Granger, Niven R Narain and 3 more

Open access · greenAbstract readComparative StudyMulticenter StudyObservational Study
PubMed Full text at PMC Publisher
In one paragraph

Observational study in The Journal of clinical investigation, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
11citing papers in PubMed, 2 pooled it
1.0field-weighted citation impact, top 20% 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

11 citing papers in PubMed, 2 syntheses or guidelines pooled it, 17 citations in OpenAlex.

  1. Pooled it
  2. Pooled it
  3. Review
  4. Article
  5. Review
  6. Review
  7. Regulation of SARS-CoV-2 infection by diet-modulated gut microbiota.Frontiers in cellular and infection microbiology · 2023
    Review
  8. Article
  9. Concerns about the interpretation of subgroup analysis. Reply.The Journal of clinical investigation · 2022
    Article
  10. Concerns about the interpretation of subgroup analysis.The Journal of clinical investigation · 2022
    Article
  11. Review
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

13 authors at 2 institutions in 1 country.

Shilong LiSema4, Stamford, Connecticut, USA.
Rangaprasad SarangarajanBERG, Framingham, Massachusetts, USA.
Tomi JunSema4, Stamford, Connecticut, USA.
Yu-Han KaoSema4, Stamford, Connecticut, USA.
Zichen WangSema4, Stamford, Connecticut, USA.
Ke HaoSema4, Stamford, Connecticut, USA.
Emilio SchadtSema4, Stamford, Connecticut, USA.
Michael A KiebishBERG, Framingham, Massachusetts, USA.
Elder GrangerBERG, Framingham, Massachusetts, USA.
Niven R NarainBERG, Framingham, Massachusetts, USA.
Rong ChenSema4, Stamford, Connecticut, USA.
Eric E SchadtSema4, Stamford, Connecticut, USA.
Li LiSema4, Stamford, Connecticut, USA.
Sema4 (United States) · USFramingham State University · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

BACKGROUNDThe angiotensin-converting enzyme (ACE) D allele is more prevalent among African Americans compared with other races and ethnicities and has previously been associated with severe coronavirus disease 2019 (COVID-19) pathogenesis through excessive ACE1 activity. ACE inhibitors/angiotensin receptor blockers (ACE-I/ARB) may counteract this mechanism, but their association with COVID-19 outcomes has not been specifically tested in the African American population.METHODSWe identified 6218 patients who were admitted into Mount Sinai hospitals with COVID-19 between February 24 and May 31, 2020, in New York City. We evaluated whether the outpatient and in-hospital use of ACE-I/ARB is associated with COVID-19 in-hospital mortality in an African American compared with non-African American population.RESULTSOf the 6218 patients with COVID-19, 1138 (18.3%) were ACE-I/ARB users. In a multivariate logistic regression model, ACE-I/ARB use was independently associated with a reduced risk of in-hospital mortality in the entire population (OR, 0.655; 95% CI, 0.505-0.850; P = 0.001), African American population (OR, 0.44; 95% CI, 0.249-0.779; P = 0.005), and non-African American population (OR, 0.748, 95% CI, 0.553-1.012, P = 0.06). In the African American population, in-hospital use of ACE-I/ARB was associated with improved mortality (OR, 0.378; 95% CI, 0.188-0.766; P = 0.006), whereas outpatient use was not (OR, 0.889; 95% CI, 0.375-2.158; P = 0.812). When analyzing each medication class separately, ARB in-hospital use was significantly associated with reduced in-hospital mortality in the African American population (OR, 0.196; 95% CI, 0.074-0.516; P = 0.001), whereas ACE-I use was not associated with impact on mortality in any population.CONCLUSIONIn-hospital use of ARB was associated with a significant reduction in in-hospital mortality among COVID-19-positive African American patients.FUNDINGNone.

Indexed as

Black or African AmericanCOVID-19COVID-19 Drug TreatmentAgedAngiotensin-Converting Enzyme InhibitorsAngiotensin Receptor AntagonistsDisease-Free SurvivalFemaleHospital MortalityHumansMaleMiddle AgedPeptidyl-Dipeptidase ARetrospective StudiesSARS-CoV-2Survival RateACE protein, humanAngiotensin-Converting Enzyme InhibitorsAngiotensin Receptor AntagonistsPeptidyl-Dipeptidase ACardiovascular diseaseCOVID-19Drug therapyEpidemiology

Identifiers

PMID34411004
PMCPMC8483748
OpenAlexW3194390088

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.