Evidence map›Paper›PMID 36003039›Full record

ArticleFamily practice2023

Mortality from angiotensin-converting enzyme-inhibitors and angiotensin receptor blockers in people infected with COVID-19: a cohort study of 3.7 million people.

Hajira Dambha-Miller, William Hinton, Christopher R Wilcox, Agnieszka Lemanska, Mark Joy, Michael Feher, Beth Stuart, Simon de Lusignan, Julia Hippisley-Cox, Simon Griffin

Open access · greenAbstract read
In one paragraph

Article in Family practice, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
0.7field-weighted citation impact, top 30% 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

4 citing papers in PubMed, 7 citations in OpenAlex.

  1. Article
  2. Review
  3. Article
  4. 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

10 authors at 4 institutions in 1 country.

Hajira Dambha-MillerDivision of Primary Care and Population Health, University of Southampton, Southampton, United Kingdom.ORCID 0000-0003-0175-443X
William HintonNuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, United Kingdom.ORCID 0000-0003-4927-0901
Christopher R WilcoxDivision of Primary Care and Population Health, University of Southampton, Southampton, United Kingdom.ORCID 0000-0003-4361-0354
Agnieszka LemanskaDepartment of Clinical and Experimental Medicine, School of Health Sciences, University of Surrey, Surrey, United Kingdom.ORCID 0000-0003-4849-2430
Mark JoyDepartment of Clinical and Experimental Medicine, School of Health Sciences, University of Surrey, Surrey, United Kingdom.ORCID 0000-0002-4974-3724
Michael FeherNuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, United Kingdom.
Beth StuartDivision of Primary Care and Population Health, University of Southampton, Southampton, United Kingdom.ORCID 0000-0001-5432-7437
Simon de LusignanNuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, United Kingdom.ORCID 0000-0002-8553-2641
Julia Hippisley-CoxNuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, United Kingdom.ORCID 0000-0002-2479-7283
Simon GriffinDepartment of Public Health and Primary Care, University of Cambridge, Cambridge, United Kingdom.
University of Oxford · GBUniversity of Southampton · GBUniversity of Surrey · GBUniversity of Cambridge · GB

Funding

British Heart Foundation FS/14/55/30806Cancer Research UK C5255/A18085Department of Health SPCR2014-10043Medical Research Council MC_UU_00006/6Medical Research Council MC_UU_12015/4Medical Research Council MR/V027778/1
6 · The paper itself

Abstract

backgroundConcerns have been raised that angiotensin-converting enzyme-inhibitors (ACE-I) and angiotensin receptor blockers (ARBs) might facilitate transmission of severe acute respiratory syndrome coronavirus 2 leading to more severe coronavirus disease (COVID-19) disease and an increased risk of mortality. We aimed to investigate the association between ACE-I/ARB treatment and risk of death amongst people with COVID-19 in the first 6 months of the pandemic.

methodsWe identified a cohort of adults diagnosed with either confirmed or probable COVID-19 (from 1 January to 21 June 2020) using computerized medical records from the Oxford-Royal College of General Practitioners (RCGP) Research and Surveillance Centre (RSC) primary care database. This comprised 465 general practices in England, United Kingdom with a nationally representative population of 3.7 million people. We constructed mixed-effects logistic regression models to quantify the association between ACE-I/ARBs and all-cause mortality among people with COVID-19, adjusted for sociodemographic factors, comorbidities, concurrent medication, smoking status, practice clustering, and household number.

resultsThere were 9,586 COVID-19 cases in the sample and 1,463 (15.3%) died during the study period between 1 January 2020 and 21 June 2020. In adjusted analysis ACE-I and ARBs were not associated with all-cause mortality (adjusted odds ratio [OR] 1.02, 95% confidence interval [CI] 0.85-1.21 and OR 0.84, 95% CI 0.67-1.07, respectively).

conclusionUse of ACE-I/ARB, which are commonly used drugs, did not alter the odds of all-cause mortality amongst people diagnosed with COVID-19. Our findings should inform patient and prescriber decisions concerning continued use of these medications during the pandemic.

Indexed as

COVID-19HypertensionAdultAngiotensin-Converting Enzyme InhibitorsAngiotensin Receptor AntagonistsAngiotensinsCohort StudiesHumansAngiotensin-Converting Enzyme InhibitorsAngiotensin Receptor AntagonistsAngiotensinsCOVID-19medicationmortality

Identifiers

PMID36003039
PMCPMC9452130
OpenAlexW4293101710

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.