Association of RASis and HMG?CoA reductase inhibitors with clinical manifestations in coronavirus disease 2019 patients: Results from the Khorshid Coronavirus Disease Cohort Study

Bijan Iraj, Amir Reza Moravejolahkami, Ramin Sami, Maryam Riahinezhad, Zahra Tasdighi, Arash Toghyani, Nastaran Sadat Hosseini, Fatemeh Dehghan Niri, Gholamreza Askari


Background: Angiotensin II receptor blockers (ARBs) and  ngiotensin?converting enzyme inhibitors (ACEinhs) may deteriorate or improve the clinical manifestations in severe acute respiratory syndrome coronavirus 2 infection. A comparative, cross?sectional study was conducted to evaluate the association of ARBs/ACEinhs and  ydroxy?3?methyl?glutaryl?CoA reductase inhibitors (HMGRis) with clinical outcomes in coronavirus disease 2019 (COVID?19).

Materials and Methods: From April 4 to June 2, 2020, 659 patients
were categorized according to whether they were taking ARB, ACEinh, or HMGRi drugs or none of them. Demographic variables, clinical and  aboratory tests, chest computed tomography findings, and intensive care unit?related data were analyzed and compared between the groups.

Results: The ARB, ACEinh, and HMGRi groups significantly had lower heart rate (P < 0.05). Furthermore, a lower percent of O2 saturation (89.34 ± 7.17% vs. 84.25 ± 7.00%; P = 0.04) was observed in the ACEis group than non?ACEinhs. Mortality rate and the number of intubated patients were lower in patients taking ARBs, ACEinhs, and HMGRis, although these differences failed to reach statistical significance.

Conclusion: Our findings present clinical data on the association between ARBs, ACEinhs, and HMGRis and outcomes in hospitalized, hypertensive COVID?19 patients, implying that ARBs/ACEinhs are not associated with
the severity or mortality of COVID?19 in such patients.


Coronavirus disease 2019, critical care, hydroxymethylglutaryl?CoA reductase inhibitors, renin–angiotensin system, severe acute respiratory syndrome coronavirus 2, X?ray computed tomography

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