Mortality from angiotensin-converting enzyme-inhibitors and angiotensin receptor blockers in people infected with COVID-19: a cohort study of 3.7 million people

Dambha-Miller, H; Hinton, W; Wilcox, CR; Lemanska, A; Joy, M; Feher, M; Stuart, B; de Lusignan, S; Hippisley-Cox, J; Griffin, S

Journal article

Mortality from angiotensin-converting enzyme-inhibitors and angiotensin receptor blockers in people infected with COVID-19: a cohort study of 3.7 million people

Abstract:: Background Concerns have been raised that angiotensin-converting enzyme-inhibitors (ACE-I) and angiotensin receptor blockers (ARBs) might facilitate transmission of severe acute respiratory syndrome coronavirus 2 leading to more severe coronavirus disease (COVID-19) disease and an increased risk of mortality. We aimed to investigate the association between ACE-I/ARB treatment and risk of death amongst people with COVID-19 in the first 6 months of the pandemic. Methods We identified a cohort of adults diagnosed with either confirmed or probable COVID-19 (from 1 January to 21 June 2020) using computerized medical records from the Oxford-Royal College of General Practitioners (RCGP) Research and Surveillance Centre (RSC) primary care database. This comprised 465 general practices in England, United Kingdom with a nationally representative population of 3.7 million people. We constructed mixed-effects logistic regression models to quantify the association between ACE-I/ARBs and all-cause mortality among people with COVID-19, adjusted for sociodemographic factors, comorbidities, concurrent medication, smoking status, practice clustering, and household number. Results There were 9,586 COVID-19 cases in the sample and 1,463 (15.3%) died during the study period between 1 January 2020 and 21 June 2020. In adjusted analysis ACE-I and ARBs were not associated with all-cause mortality (adjusted odds ratio [OR] 1.02, 95% confidence interval [CI] 0.85–1.21 and OR 0.84, 95% CI 0.67–1.07, respectively). Conclusion Use of ACE-I/ARB, which are commonly used drugs, did not alter the odds of all-cause mortality amongst people diagnosed with COVID-19. Our findings should inform patient and prescriber decisions concerning continued use of these medications during the pandemic.

Publication status:: Published

Peer review status:: Peer reviewed

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APA Style

Dambha-Miller, H., Hinton, W., Wilcox, C. R., Lemanska, A., Joy, M., Feher, M., Stuart, B., de Lusignan, S., Hippisley-Cox, J., & Griffin, S. (2022). Mortality from angiotensin-converting enzyme-inhibitors and angiotensin receptor blockers in people infected with COVID-19: a cohort study of 3.7 million people. Family Practice, 40(2), 330–337.

MLA Style

Dambha-Miller, H., et al. “Mortality from Angiotensin-Converting Enzyme-Inhibitors and Angiotensin Receptor Blockers in People Infected with COVID-19: a Cohort Study of 3.7 Million People.” Family Practice, vol. 40, no. 2, Oxford University Press, 2022, pp. 330–37.

Chicago Style

Dambha-Miller, H, W Hinton, CR Wilcox, A Lemanska, M Joy, M Feher, B Stuart, S de Lusignan, J Hippisley-Cox, and S Griffin. 2022. “Mortality from Angiotensin-Converting Enzyme-Inhibitors and Angiotensin Receptor Blockers in People Infected with COVID-19: a Cohort Study of 3.7 Million People.” Family Practice 40 (2): 330–37.
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