No Evidence Found to Support Discontinuing ACEIs, ARBs in COVID-19
Mean number of days alive and out of hospital not significantly different for those discontinuing, continuing meds
TUESDAY, Jan. 26, 2021 (HealthDay News) -- For patients taking angiotensin-converting enzyme inhibitors (ACEIs) or angiotensin II receptor blockers (ARBs) and hospitalized with mild-to-moderate COVID-19, there is no significant difference in the mean number of days alive and out of the hospital with discontinuation or continuation of these medications, according to a study published in the Jan. 19 issue of the Journal of the American Medical Association.
Renato D. Lopes, M.D., Ph.D., from the D'Or Institute for Research and Education in Rio de Janeiro, and colleagues examined the impact of discontinuation versus continuation of ACEIs or ARBs on the number of days alive and out of hospital through 30 days among 659 patients hospitalized with mild-to-moderate COVID-19. Of the patients, 334 and 325 discontinued and continued ACEIs or ARBs, respectively.
The researchers observed no significant between-group difference in the number of days alive and out of the hospital (mean, 21.9 versus 22.9 for the discontinuation versus continuation groups; mean ratio, 0.95; 95 percent confidence interval, 0.90 to 1.01). The discontinuation and continuation groups showed no statistically significant difference in regards to death (2.7 versus 2.8 percent; odds ratio, 0.97; 95 percent confidence interval, 0.38 to 2.52), cardiovascular death (0.6 versus 0.3 percent; odds ratio, 1.95; 95 percent confidence interval, 0.19 to 42.12), or COVID-19 progression (38.3 versus 32.3 percent; odds ratio, 1.30; 95 percent confidence interval, 0.95 to 1.80).
"These findings do not support routinely discontinuing ACEIs or ARBs among patients hospitalized with mild-to-moderate COVID-19 if there is an indication for treatment," the authors write.
Several authors disclosed financial ties to the pharmaceutical industry.