OUTCOMES OF PATIENTS WITH COVID-19 ON ANTIHYPERTENSIVE MEDICATIONS IN SOUTHERN PENNSYLVANIA

Abstract

TOPIC: Chest Infections TYPE: Original Investigations PURPOSE: The controversy surrounding the association of ACE inhibitor (ACEi) use in the COVID-19 pandemic has been well documented. Since then, studies have been published refuting the findings. While there was a recent study in France on hypertensive patients on one of ACEi, angiotensin II receptor blocker (ARB) or calcium channel blocker (CCB), we performed a retrospective study reviewing the outcomes (i.e. admissions, readmission and mortality) associated with COVID-19 patients and their use of anti-hypertensive medications (anti-HTNs), specifically ACEi/ARB, thiazides, beta blocker (BB) and CCB, to look at the outcomes associated with their use, regardless of their roles in anti-hypertensive management. METHODS: We performed a retrospective study on patients with a positive COVID-19 RT-PCR test since January 2019. 606 adult patients were randomly selected. Data on demographics, co-morbidities, admission status, length of stay, types of anti-hypertensives and outcomes were collected and reviewed. RESULTS: Our study demonstrated the use of ACEi (24.1%) and thiazides (17.5%) had a reduced rate of admission when compared to patients on BB (32.3%) or CCB (32.4%). It should be noted thiazides were not as widely used (n = 63) in our population. Thus, it was not possible to comment on whether its use had a role in preventing hospitalization. Among the agents, ACEi is widely used for a multitude of diseases. As a result, it is often a first line agent employed by many, which was consistent with the data (n = 294) collected in this study. Interestingly, when assessing readmission rates, ACEi had the lowest percentage (8.1%;6/74) among the classes (BB 13.3%;8/60, CCB 18.4%;7/38, Thiazide 15.4%;2/13). Its judicious use and lower rates of admission and readmission were perhaps a compliment to the fine work by the physicians involved in their care.For mortality, there was a minimal percentage difference across the classes (ACEi 25.7%, BB 23.3%, CCB 23.7%, thiazides 23.1%). While there was a difference in number of patients across all four medications, the similar mortality suggested the co-morbidities, rather than the medications, may have a stronger influence on the outcomes in these patients. CONCLUSIONS: Our study demonstrated ACEi had a reduced rate of admission and the lowest rate of readmission compared to patients on BB or CCB. There was no difference in mortality across all four anti-hypertensive classes. We believe studies assessing co-morbidities while controlling for anti-hypertensive use could be beneficial in further our understanding in predicting outcomes of COVID-19 patients. CLINICAL IMPLICATIONS: ACEi use did not appear to have higher admission rates than other anti-hypertensives. Its use resulted in the lowest re-admission rates. The use of specific anti-hypertensive class had no bearing on mortality rates of COVID-19 patients. DISCLOSURES: No relevant relationships by Ali AKRAM, source=Web Response No relevant relationships by Vernon Chan, source=Web Response No relevant relationships by Dana Daoud, source=Web Response No relevant relationships by Olufunmilayo Folaranmi, source=Web Response No relevant relationships by Christopher Hemsley, source=Web Response No relevant relationships by Hafiza Wajeeha Javaid, source=Web Response No relevant relationships by Sarah Maurice, source=Web Response No relevant relationships by Junaid mir, source=Web Response No relevant relationships by Aisha Parihar, source=Web Response No relevant relationships by Britney Plotnick, source=Web Response No relevant relationships by Jayaram Thimmapuram, source=Web Response