Cardiovascular drugs may not be associated with poor COVID-19 outcomes

Objectives:
Are cardiovascular drugs associated with poor COVID-19 outcomes?

Study design:
This review article included 390 studies.

Results and conclusions:   
The investigators found the most-reported drugs were angiotensin-converting enzyme inhibitors (ACEIs)/angiotensin receptor blockers (ARBs) with ACEI/ARB exposure having borderline association with confirmed COVID-19 infection [OR = 1.14, 95% CI = 1.00 to 1.31].

The investigators found among COVID-19 patients, unadjusted estimates showed that ACEI/ARB exposure was significantly associated with hospitalization [OR = 1.76, 95% CI = 1.34 to 2.32], disease severity [OR = 1.40, 95% CI = 1.26 to 1.55] and all-cause mortality [OR = 1.22, 95% CI = 1.12 to 1.33] but not hospitalization length [mean difference = -0.27, 95% CI = -1.36 to 0.82 days].

The investigators found after adjustment, ACEI/ARB exposure was not significantly associated with confirmed COVID-19 infection [OR = 0.92, 95% CI = 0.71 to 1.19], hospitalization [OR = 0.93, 95% CI = 0.70 to 1.24], disease severity [OR = 1.05, 95% CI = 0.81 to 1.38] or all-cause mortality [OR = 0.84, 95% CI = 0.70 to 1.00].

The investigators found, similarly, subgroup analyses involving only hypertensive patients revealed that ACEI/ARB exposure was not significantly associated with confirmed COVID-19 infection [OR = 0.93, 05% CI = 0.79 to 1.09], hospitalization [OR = 0.84, 95% CI = 0.58 to 1.22], hospitalization length [mean difference = -0.14, 95% CI = -1.65 to 1.36 days], disease severity [OR = 0.92, 95% CI = 0.76 to 1.11] while it decreased the odds of dying [OR = 0.76, 95% CI = 0.65 to 0.88].

The investigators found a similar trend was observed for other cardiovascular drugs.

The investigators concluded cardiovascular drugs are not associated with poor COVID-19 outcomes in adjusted analyses. Patients should continue taking these drugs as prescribed. However, the validity of these findings is limited by a high level of heterogeneity and serious risk of bias.

Original title:
Cardiovascular drugs and COVID-19 clinical outcomes: a living systematic review and meta-analysis by Asiimwe IG, Pushpakom S, […], Pirmohamed M.

Link:
https://pubmed.ncbi.nlm.nih.gov/34101232/

Additional information of El Mondo:
Find more information/studies on cardiovascular diseases and coronavirus right here.