TORNA ALL’ELENCO

ACE-I and ARBS do not influence the chest CT presentation and 1-year survival of COVID-19 patients: Italian multicentre registry in European Heart Journal, Supplement

2021
AOU Città della Salute di Torino

Tipo pubblicazione

Conference Abstract

Autori/Collaboratori (22)Vedi tutti...

Maestrini V
Department of Clinical, Internal, Anesthesiology and Cardiovascular Sciences, Sapienza University of Rome, Italy
Mancone M
Department of Clinical, Internal, Anesthesiology and Cardiovascular Sciences, Sapienza University of Rome, Italy
Colaiacomo MC
Division of Cardiology, Department of Medical Sciences, AOU Città della Salute e della Scienza, University of Turin, Italy

et alii...

Abstract

Aims: A possible interference between ACE-i or ARBs with ACE-2 receptor and SARSCoV- 2 pathway has been raised. Despite data have shown no clinical impact of therapy with ACE-I or ARBs on COVID-19, these drugs are often discontinued upon hospitalization or diagnosis. To evaluate the effects of cardiovascular risk factors (CVRF) and prior outpatient therapy with RAAS inhibitors on the chest CT severity score performed within 24 h of diagnosis of SARS-CoV-2 infection (before stopping medications or starting specific therapy for COVID-19) and on 1-year survival. Methods and results: This is a multicentre, prospective, observational study. All admitted patients diagnosed with SARS-CoV-2 infection who performed chest CT within 24 h of arrival were consecutively enrolled from 1 March to 1 June 2020. A severity score was attributed to Chest CT by two radiologists in blind to the patient's clinical information and a cut-off value of 19.5 was considered to define severe radiological pneumonia. A 1-year telephone follow-up was performed in order to evaluate the determinants of 1-year survival. 590 patients with a mean age of 63±14 years were included. Seventy-three (12.4%) patients were treated with ACE-I, 85 (14.4%) with ARBs and 62 (10.5%) with CCB. Cox regression analysis showed that male gender (OR: 1.4; 95% CI: from 1.02 to 2.07; P=0.035), diabetes (OR: 1.6; 95% CI: from 1.03 to 2.7; P=0.037), age (OR: 1.02; 95% CI: from 1.008 to 1.033; P=0.001), and obesity (OR: 3.04; 95% CI: from 1.3 to 6.7; P<0.001) were independently associated with a severe CT score. Of note, while prior outpatient therapy with ACE-I and ARBs was not independently associated with severe CT score, therapy with CCB was independently associated with a severe CT score (OR: 1.9, 95% CI: from 1.05 to 3.4, P=0.033). Severe chest CT severity score (OR: 1.05; 95% CI: from 1.02 to 1.08; P<0.001), P/F ratio (OR: 0.998; 95% CI: from 0.994 to 0.998; P<0.001), and older age (OR: 1.06; 95% CI: from 1.03 to

DOI : 10.1093/eurheartj/suab135.007

Keywords

aged; adult; endogenous compound; dipeptidyl carboxypeptidase; thorax; telephone; survivor; radiologist; prospective study; outpatient care; observational study; obesity; multicenter study; mortality; middle aged; male; major clinical study; insulin dependent diabetes mellitus; human; gender; Horowitz index; follow up; female; diagnosis; coronavirus disease 2019; conference abstract;