Evidence map›Paper›PMID 35414547›Full record

ArticleBMJ open2022

What is the association of renin-angiotensin-aldosterone system inhibitors with COVID-19 outcomes: retrospective study of racially diverse patients?

Yulia Khodneva, Gargya Malla, Stephen Clarkson, Richard Fu, Monika M Safford, Parag Goyal, Suzanne Oparil, Andrea L Cherrington, Elizabeth A Jackson, James Willig

Abstract read
In one paragraph

Article in BMJ open, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing 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

1 citing paper in PubMed.

  1. Review
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

10 authors.

Yulia KhodnevaDepartment of Medicine, Heersink School of Medicine, UAB, Birmingham, Alabama, USA ykhodneva@uabmc.edu.ORCID 0000-0001-5848-8019
Gargya MallaDepartment of Epidemiology, School of Public Health, UAB, Birmingham, Alabama, USA.
Stephen ClarksonDivision of Cardiology, Department of Medicine, Heersink School of Medicine, UAB, Birmingham, Alabama, USA.
Richard FuDepartment of Medicine, Heersink School of Medicine, UAB, Birmingham, Alabama, USA.
Monika M SaffordDepartment of Medicine, Weill Cornell Medicine, New York, New York, USA.
Parag GoyalDivision of Cardiology, Department of Medicine, Weill Cornell Medicine, New York, New York, USA.
Suzanne OparilDivision of Cardiology, Department of Medicine, Heersink School of Medicine, UAB, Birmingham, Alabama, USA.
Andrea L CherringtonDepartment of Medicine, Heersink School of Medicine, UAB, Birmingham, Alabama, USA.
Elizabeth A JacksonDivision of Cardiology, Department of Medicine, Heersink School of Medicine, UAB, Birmingham, Alabama, USA.
James WilligDepartment of Medicine, Heersink School of Medicine, UAB, Birmingham, Alabama, USA.

Funding

UAB Center for Clinical and Translational Science (CCTS)UL1TR001417 · NCATS · UNIVERSITY OF ALABAMA AT BIRMINGHAM · PI KIMBERLY, ROBERT P. · 2015 to 2018
$31.4M
MECHANISMS OF HYPERTENSION AND CARDIOVASCULAR DISEASEST32HL007457 · NHLBI · UNIVERSITY OF ALABAMA AT BIRMINGHAM · PI Martin E Young · 1985 to 2026
$8.6M
NCATS NIH HHS UL1 TR001417NHLBI NIH HHS T32 HL007457
6 · The paper itself

Abstract

objectiveTo describe the clinical outcomes of COVID-19 in a racially diverse sample from the US Southeast and examine the association of renin-angiotensin-aldosterone system (RAAS) inhibitor use with COVID-19 outcome. DESIGN, SETTING,

participantsThis study is a retrospective cohort of 1024 patients with reverse-transcriptase PCR-confirmed COVID-19 infection, admitted to a 1242-bed teaching hospital in Alabama. Data on RAAS inhibitors use, demographics and comorbidities were extracted from hospital medical records. PRIMARY OUTCOMES: In-hospital mortality, a need of intensive care unit, respiratory failure, defined as invasive mechanical ventilation (iMV) and 90-day same-hospital readmissions.

resultsAmong 1024 patients (mean (SD) age, 57 (18.8) years), 532 (52.0%) were African Americans, 514 (50.2%) male, 493 (48.1%) had hypertension, 365 (36%) were taking RAAS inhibitors. During index hospitalisation (median length of stay of 7 (IQR (4-15) days) 137 (13.4%) patients died; 170 (19.2%) of survivors were readmitted. RAAS inhibitor use was associated with lower in-hospital mortality (adjusted HR, 95% CI (0.56, (0.36 to 0.88), p=0.01) and no effect modification by race was observed (p for interaction=0.81). Among patients with hypertension, baseline RAAS use was associated with reduced risk of iMV, adjusted OR, 95% CI (aOR 0.58, 95% CI 0.36 to 0.95, p=0.03). Patients with heart failure were twice as likely to die from COVID-19, compared with patients without heart failure.

conclusionsIn a retrospespective study of racially diverse patients, hospitalised with COVID-19, prehospitalisation use of RAAS inhibitors was associated with 40% reduction in mortality irrespective of race.

Indexed as

COVID-19 Drug TreatmentHeart FailureHypertensionAngiotensin-Converting Enzyme InhibitorsAngiotensin Receptor AntagonistsAntihypertensive AgentsHumansMaleMiddle AgedRenin-Angiotensin SystemRetrospective StudiesAngiotensin-Converting Enzyme InhibitorsAngiotensin Receptor AntagonistsAntihypertensive AgentsCOVID-19EPIDEMIOLOGYGENERAL MEDICINE (see Internal Medicine)

Identifiers

PMID35414547
PMCPMC9006195

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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.