Evidence map›Paper›PMID 38913169›Full record

ArticleEuropean journal of clinical pharmacology2024

Use of drugs for hypertension or heart failure and the risk of death in COVID-19: association with loop-diuretics.

Johan Fastbom, Gudrun Jonasdottir Bergman, Johanna Holm, Håkan Hanberger, Kristoffer Strålin, Sten Walther, Joakim Alfredsson, Maria State, Natalia Borg, Anastasia Nyman Iliadou

Abstract read
In one paragraph

Article in European journal of clinical pharmacology, 2024. 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. Do angiotensin-converting enzyme inhibitors reduce the risk of death in COVID-19? Yes.Hypertension research : official journal of the Japanese Society of Hypertension · 2026
    Article
  2. Article
  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

10 authors.

Johan FastbomNational Board of Health and Welfare (Socialstyrelsen), Stockholm, Sweden. johan.fastbom@socialstyrelsen.se.
Gudrun Jonasdottir BergmanNational Board of Health and Welfare (Socialstyrelsen), Stockholm, Sweden.
Johanna HolmNational Board of Health and Welfare (Socialstyrelsen), Stockholm, Sweden.
Håkan HanbergerDepartment of Clinical and Experimental Medicine, Infectious Diseases, Faculty of Health Sciences, Linköping University, Linköping, Sweden.
Kristoffer StrålinDepartment of Infectious Diseases, Karolinska University Hospital, Stockholm, Sweden.
Sten WaltherDepartment of Cardiothoracic and Vascular Surgery. Heart Centre, Linköping University Hospital and Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden.
Joakim AlfredssonDepartment of Health Medicine and Caring Sciences and Department of Cardiology, Linköping University, Linköping, Sweden.
Maria StateNational Board of Health and Welfare (Socialstyrelsen), Stockholm, Sweden.
Natalia BorgNational Board of Health and Welfare (Socialstyrelsen), Stockholm, Sweden.
Anastasia Nyman IliadouNational Board of Health and Welfare (Socialstyrelsen), Stockholm, Sweden.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeTo study the association between the use of drugs for hypertension or heart failure, particularly diuretics, and risk of death in COVID-19.

methodsWe conducted a cohort study, based on record linked individual-based data from national registers, of all Swedish inhabitants 50 years and older (n = 3,909,321) at the start of the first SARS-CoV-2 wave in Sweden. The association between use of angiotensin-converting enzyme inhibitors (ACEI), angiotensin II receptor blockers (ARB), thiazides, loop diuretics, aldosterone antagonists, beta blocking agents and calcium channel blockers at the index date 6 March 2020, and death in COVID-19 during 7 March to 31 July 2020, was analysed using Cox-proportional hazards regression, adjusted for a wide range of possible confounders.

resultsUse of loop diuretics was associated with higher risk [adjusted hazard ratio (HR) 1.26; 95% confidence interval (95% CI) 1.17-1.35] and thiazides with reduced risk (0.78; 0.69-0.88) of death in COVID-19. In addition, lower risk was observed for ACEI and higher risk for beta-blocking agents, although both associations were weak. For ARB, aldosterone antagonists and calcium channel blockers no significant associations were found.

conclusionIn this nationwide cohort of nearly 4 million persons 50 years and older, the use of loop diuretics was associated with increased risk of death in COVID-19 during the first SARS-CoV-2 wave in Sweden. This contrasted to the decreased risk observed for thiazides. As treatment with loop diuretics is common, particularly in the elderly, the group most affected by severe COVID-19, this finding merit further investigation.

Indexed as

COVID-19Heart FailureHypertensionAgedAged, 80 and overAngiotensin-Converting Enzyme InhibitorsAngiotensin Receptor AntagonistsAntihypertensive AgentsCohort StudiesFemaleHumansMaleMiddle AgedProportional Hazards ModelsRegistriesSARS-CoV-2Angiotensin-Converting Enzyme InhibitorsAngiotensin Receptor AntagonistsAntihypertensive AgentsSodium Potassium Chloride Symporter InhibitorsAngiotensin-converting enzyme inhibitorsCOVID-19Loop diureticsThiazide diuretics

Identifiers

PMID38913169
PMCPMC11393138

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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.