Objective: The hypothesis that been set forward that use of Renin Angiotensin Aldosterone System (RAAS) inhibitors is associated with COVID-19 severity. We set-up a multicenter Italian collaboration (CORIST Project, ClinicalTrials.gov ID: NCT04318418) to retrospectively investigate the relationship between RAAS inhibitors and COVID-19 in-hospital mortality. We also carried out an updated meta-analysis on the relevant studies. Methods: We analyzed 4,069 unselected patients with laboratory-confirmed SARS-CoV-2 infection and hospitalized in 34 clinical centers in Italy from February 19, 2020 to May 23, 2020. The primary end-point in a time-to event analysis was in-hospital death, comparing patients who received angiotensin-converting-enzyme inhibitors (ACE-I) or angiotensin-receptor blockers (ARB) with patients who did not. Articles for the meta-analysis were retrieved until July 13th, 2020 by searching in web-based libraries, and data were combined using the general variance-based method. Results: Out of 4,069 COVID-19 patients, 13.5% and 13.3% received ACE-I or ARB, respectively. Use of neither ACE-I nor ARB was associated with mortality (multivariable hazard ratio (HR) adjusted also for COVID-19 treatments: 0.96, 95% confidence interval 0.77-1.20 and HR=0.89, 0.67-1.19 for ACE-I and ARB, respectively). Findings were similar restricting the analysis to hypertensive (N=2,057) patients (HR=1.00, 0.78-1.26 and HR=0.88, 0.65-1.20) or when ACE-I or ARB were considered as a single group. Results from the meta-analysis (19 studies, 29,057 COVID-19 adult patients, 9,700 with hypertension) confirmed the absence of association. Conclusions: In this observational study and meta-analysis of the literature, ACE-I or ARB use was not associated with severity or in-hospital mortality in COVID-19 patients.
Di Castelnuovo, A., Costanzo, S., Antinori, A., Berselli, N., Blandi, L., Bonaccio, M., et al. (2020). RAAS inhibitors are not associated with mortality in COVID-19 patients: findings from an observational multicenter study in Italy and a meta-analysis of 19 studies. VASCULAR PHARMACOLOGY, 135.
|Citazione:||Di Castelnuovo, A., Costanzo, S., Antinori, A., Berselli, N., Blandi, L., Bonaccio, M., et al. (2020). RAAS inhibitors are not associated with mortality in COVID-19 patients: findings from an observational multicenter study in Italy and a meta-analysis of 19 studies. VASCULAR PHARMACOLOGY, 135.|
|Tipo:||Articolo in rivista - Articolo scientifico|
|Carattere della pubblicazione:||Scientifica|
|Presenza di un coautore afferente ad Istituzioni straniere:||No|
|Titolo:||RAAS inhibitors are not associated with mortality in COVID-19 patients: findings from an observational multicenter study in Italy and a meta-analysis of 19 studies|
|Autori:||Di Castelnuovo, A; Costanzo, S; Antinori, A; Berselli, N; Blandi, L; Bonaccio, M; Cauda, R; Gialluisi, A; Guaraldi, G; Menicanti, L; Mennuni, M; Mussinelli, R; My, I; Parruti, G; Patti, G; Perlini, S; Santilli, F; Signorelli, C; Stefanini, G; Vergori, A; Abete, P; Ageno, W; Agostoni, P; Aiello, L; Al Moghazi, S; Arboretti, R; Aucella, F; Barbieri, G; Barchitta, M; Bartoloni, A; Bonfanti, P; Cacciatore, F; Caiano, L; Carrozzi, L; Cascio, A; Castiglione, G; Cianfrone, S; Ciccullo, A; Cingolani, A; Cipollone, F; Colomba, C; Colombo, C; Cozzi, O; Crisetti, A; Crosta, F; Danzi, G; D'Ardes, D; de Gaetano Donati, K; Di Gennaro, F; Di Tano, G; D'Offizi, G; Fusco, F; Gentile, I; Graziani, E; Guarnieri, G; Larizza, G; Leone, A; Lio, V; Lucia, M; Maccagni, G; Madaro, F; Maitan, S; Mancarella, S; Manuele, R; Mapelli, M; Maragna, R; Marcucci, R; Maresca, G; Marongiu, S; Marotta, C; Marra, L; Mastroianni, F; Mazzitelli, M; Mengozzi, A; Menichetti, F; Meschiari, M; Milic, J; Minutolo, F; Molena, B; Mussini, C; Musso, M; Odone, A; Olivieri, M; Palimodde, A; Pasi, E; Pesavento, R; Petri, F; Pinchera, B; Pivato, C; Poletti, V; Ravaglia, C; Rossato, M; Rossi, M; Sabena, A; Salinaro, F; Sangiovanni, V; Sanrocco, C; Scoppettuolo, G; Scorzolini, L; Sgariglia, R; Simeone, P; Trecarichi, E; Vettor, R; Vianello, A; Vinceti, M; Virano, A; Vocciante, L; Iacoviello, L; De Caterina, R|
|Data di pubblicazione:||2020|
|Digital Object Identifier (DOI):||http://dx.doi.org/10.1016/j.vph.2020.106805|
|Appare nelle tipologie:||01 - Articolo su rivista|