Association of Renin-angiotensin-aldosterone System Inhibitors With Coronavirus Disease 2019 (COVID-19)- Related Outcomes in Korea: A Nationwide Population-based Cohort Study

Abstract Background Renin-angiotensin-aldosterone system (RAAS) inhibitors may facilitate host cell entry of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) or attenuate organ injury via RAAS blockade. We aimed to assess the associations between prior use of RAAS inhibitors and clinical...

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Bibliographic Details
Published in:Clinical infectious diseases 2020-11, Vol.71 (16), p.2121-2128
Main Authors: Jung, Sun-Young, Choi, Jae Chol, You, Seung-Hun, Kim, Won-Young
Format: Article
Language:English
Subjects:
Adolescent
Adult
Aged
Aged, 80 and over
and Commentaries
Angiotensin Receptor Antagonists - therapeutic use
Angiotensin-Converting Enzyme Inhibitors - therapeutic use
Cohort Studies
COVID-19 - mortality
Female
Humans
Male
Middle Aged
Multivariate Analysis
Odds Ratio
Renin-Angiotensin System - drug effects
Republic of Korea - epidemiology
SARS-CoV-2 - pathogenicity
Young Adult
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Summary:Abstract Background Renin-angiotensin-aldosterone system (RAAS) inhibitors may facilitate host cell entry of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) or attenuate organ injury via RAAS blockade. We aimed to assess the associations between prior use of RAAS inhibitors and clinical outcomes among Korean patients with coronavirus disease 2019 (COVID-19). Methods We performed a nationwide population-based cohort study using the Korean Health Insurance Review and Assessment database. Claim records were screened for 69 793 individuals who were tested for COVID-19 until 8 April 2020. Adjusted odds ratios (ORs) were used to compare the clinical outcomes between RAAS inhibitor users and nonusers. Results Among 5179 confirmed COVID-19 cases, 762 patients were RAAS inhibitor users and 4417 patients were nonusers. Relative to nonusers, RAAS inhibitor users were more likely to be older, male, and have comorbidities. Among 1954 hospitalized patients with COVID-19, 377 patients were RAAS inhibitor users, and 1577 patients were nonusers. In-hospital mortality was observed for 33 RAAS inhibitor users (9%) and 51 nonusers (3%) (P 
ISSN:1058-4838
1537-6591
1537-6591
DOI:10.1093/cid/ciaa624