COVID-19 and RAS inhibitors: meta-analysis shows survival benefit

  • Guo X & al.
  • Hypertension
  • 27/05/2020

  • Emily Willingham, PhD
  • Clinical Essentials
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Takeaway

  • Patients with COVID-19 who are taking renin-angiotensin system (RAS) inhibitors for hypertension have a significant survival benefit vs those not taking the drugs.
  • This meta-analysis found no association between taking RAS inhibitors and COVID-19 severity.

Why this matters

  • The findings are in keeping with accumulating evidence that patients taking these drugs should at the least continue on them if they develop COVID-19.
  • This growing evidence base should quell concerns and controversy about potential negative effects of RAS inhibitors.

Key results

  • Patients with hypertension who were taking RAS inhibitors had significantly reduced mortality vs those not taking them:
    • OR, 0.57 (95% CI, 0.38-0.84; P=.004; I2=0).
  • The patient groups did not differ, however, in COVID-19 severity:
    • OR, 0.71 (95% CI, 0.46-1.08; P=.11; I2=59%).
  • No significant publication bias was detected.

Study design

  • The authors conducted a meta-analysis on data from 9 observational studies that included 3936 patients with both hypertension and COVID-19.
  • Primary outcome: COVID-19 severity.
  • Secondary outcome: COVID-19 mortality.
  • Studies were published up to May 13, 2020.
  • Funding: National Natural Science Foundation of China; Zhejiang Provincial Natural Science Foundation of China.

Limitations

  • Fairly high heterogeneity among the studies regarding severity outcome.
  • All included studies were observational, although judged as high quality.