Effect of renin-angiotensin-aldosterone system inhibitors on Covid-19 patients in Korea
The effect of renin-angiotensin-aldosterone system (RAAS) inhibitors in coronavirus disease 19 (Covid-19) patients has not been fully investigated. We evaluated the association between RAAS inhibitor use and outcomes of Covid-19. This study was a retrospective observational cohort study that used da...
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| description | The effect of renin-angiotensin-aldosterone system (RAAS) inhibitors in coronavirus disease 19 (Covid-19) patients has not been fully investigated. We evaluated the association between RAAS inhibitor use and outcomes of Covid-19.
This study was a retrospective observational cohort study that used data based on insurance benefit claims sent to the Health Insurance Review and Assessment Service of Korea by May 15, 2020. These claims comprised all Covid-19 tested cases and the history of medical service use in these patients for the past five years. The primary outcome was all-cause mortality, and the rate of ventilator care was compared between the groups.
From a total of 7,590 patients diagnosed with Covid-19, two distinct cohorts were generated based on RAAS inhibitors prescribed within 6 months before Covid-19 diagnosis. A total of 1,111 patients was prescribed RAAS inhibitors, and 794 patients were prescribed antihypertensive drugs, excluding RAAS inhibitors. In propensity-score matched analysis, 666 pairs of data set were generated, and all-cause mortality of the RAAS inhibitor group showed no significant difference compared with the non-RAAS inhibitor group (14.6% vs. 11.1%; hazard ratio [HR], 0.79; 95% confidence interval [CI], 0.54-1.15; p = 0.22). The rate of ventilator care was not significantly different between the two groups (4.4% vs. 4.1%; HR, 1.04; 95%CI, 0.60-1.79; p = 0.89).
RAAS inhibitor treatment did not appear to increase the mortality of Covid-19 patients compared with other antihypertensive drugs, suggesting that they may be safely continued in Covid-19 patients. |
| doi_str_mv | 10.1371/journal.pone.0248058 |
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This study was a retrospective observational cohort study that used data based on insurance benefit claims sent to the Health Insurance Review and Assessment Service of Korea by May 15, 2020. These claims comprised all Covid-19 tested cases and the history of medical service use in these patients for the past five years. The primary outcome was all-cause mortality, and the rate of ventilator care was compared between the groups.
From a total of 7,590 patients diagnosed with Covid-19, two distinct cohorts were generated based on RAAS inhibitors prescribed within 6 months before Covid-19 diagnosis. A total of 1,111 patients was prescribed RAAS inhibitors, and 794 patients were prescribed antihypertensive drugs, excluding RAAS inhibitors. In propensity-score matched analysis, 666 pairs of data set were generated, and all-cause mortality of the RAAS inhibitor group showed no significant difference compared with the non-RAAS inhibitor group (14.6% vs. 11.1%; hazard ratio [HR], 0.79; 95% confidence interval [CI], 0.54-1.15; p = 0.22). The rate of ventilator care was not significantly different between the two groups (4.4% vs. 4.1%; HR, 1.04; 95%CI, 0.60-1.79; p = 0.89).
RAAS inhibitor treatment did not appear to increase the mortality of Covid-19 patients compared with other antihypertensive drugs, suggesting that they may be safely continued in Covid-19 patients.</description><identifier>ISSN: 1932-6203</identifier><identifier>EISSN: 1932-6203</identifier><identifier>DOI: 10.1371/journal.pone.0248058</identifier><identifier>PMID: 33705440</identifier><language>eng</language><publisher>United States: Public Library of Science</publisher><subject>ACE inhibitors ; Adolescent ; Adult ; Aged ; Aldosterone ; Angiotensin ; Angiotensin Receptor Antagonists - therapeutic use ; Angiotensin-Converting Enzyme Inhibitors - therapeutic use ; Antihypertensive agents ; Antihypertensive Agents - therapeutic use ; Antihypertensives ; Authoring ; Bladder cancer ; Cardiology ; Computer programs ; Confidence intervals ; Coronaviruses ; COVID-19 ; COVID-19 - complications ; COVID-19 - mortality ; COVID-19 - therapy ; Data analysis ; Drafting software ; Editing ; Engineering and Technology ; Epidemiology ; Female ; Graduate schools ; Graduate studies ; Health aspects ; Health care facilities ; Humans ; Hypertension - complications ; Hypertension - drug therapy ; Inhibitors ; Male ; Medicine ; Medicine and Health Sciences ; Middle Aged ; Mortality ; Patient outcomes ; Prostate cancer ; Public health ; Renin ; Renin inhibitors ; Renin-angiotensin system ; Renin-Angiotensin System - drug effects ; Republic of Korea - epidemiology ; Respiration, Artificial ; Retrospective Studies ; Social Sciences ; Software ; Stroke ; Young Adult</subject><ispartof>PloS one, 2021-03, Vol.16 (3), p.e0248058-e0248058</ispartof><rights>COPYRIGHT 2021 Public Library of Science</rights><rights>2021 Park et al. This is an open access article distributed under the terms of the Creative Commons Attribution License: http://creativecommons.org/licenses/by/4.0/ (the “License”), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>2021 Park et al 2021 Park et al</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c692t-256ad2ff61bd36f2e7da05441f19038639ed530a7495c24e0687cb6b54d2f8e63</citedby><cites>FETCH-LOGICAL-c692t-256ad2ff61bd36f2e7da05441f19038639ed530a7495c24e0687cb6b54d2f8e63</cites><orcidid>0000-0002-7794-3547 ; 0000-0001-5508-7519</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC7951918/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC7951918/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,723,776,780,860,881,2096,2915,23845,27901,27902,53766,53768,79342,79343</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/33705440$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Park, Jungchan</creatorcontrib><creatorcontrib>Lee, Seung-Hwa</creatorcontrib><creatorcontrib>You, Seng Chan</creatorcontrib><creatorcontrib>Kim, Jinseob</creatorcontrib><creatorcontrib>Yang, Kwangmo</creatorcontrib><title>Effect of renin-angiotensin-aldosterone system inhibitors on Covid-19 patients in Korea</title><title>PloS one</title><addtitle>PLoS One</addtitle><description>The effect of renin-angiotensin-aldosterone system (RAAS) inhibitors in coronavirus disease 19 (Covid-19) patients has not been fully investigated. We evaluated the association between RAAS inhibitor use and outcomes of Covid-19.
This study was a retrospective observational cohort study that used data based on insurance benefit claims sent to the Health Insurance Review and Assessment Service of Korea by May 15, 2020. These claims comprised all Covid-19 tested cases and the history of medical service use in these patients for the past five years. The primary outcome was all-cause mortality, and the rate of ventilator care was compared between the groups.
From a total of 7,590 patients diagnosed with Covid-19, two distinct cohorts were generated based on RAAS inhibitors prescribed within 6 months before Covid-19 diagnosis. A total of 1,111 patients was prescribed RAAS inhibitors, and 794 patients were prescribed antihypertensive drugs, excluding RAAS inhibitors. In propensity-score matched analysis, 666 pairs of data set were generated, and all-cause mortality of the RAAS inhibitor group showed no significant difference compared with the non-RAAS inhibitor group (14.6% vs. 11.1%; hazard ratio [HR], 0.79; 95% confidence interval [CI], 0.54-1.15; p = 0.22). The rate of ventilator care was not significantly different between the two groups (4.4% vs. 4.1%; HR, 1.04; 95%CI, 0.60-1.79; p = 0.89).
RAAS inhibitor treatment did not appear to increase the mortality of Covid-19 patients compared with other antihypertensive drugs, suggesting that they may be safely continued in Covid-19 patients.</description><subject>ACE inhibitors</subject><subject>Adolescent</subject><subject>Adult</subject><subject>Aged</subject><subject>Aldosterone</subject><subject>Angiotensin</subject><subject>Angiotensin Receptor Antagonists - therapeutic use</subject><subject>Angiotensin-Converting Enzyme Inhibitors - therapeutic use</subject><subject>Antihypertensive agents</subject><subject>Antihypertensive Agents - therapeutic use</subject><subject>Antihypertensives</subject><subject>Authoring</subject><subject>Bladder cancer</subject><subject>Cardiology</subject><subject>Computer programs</subject><subject>Confidence intervals</subject><subject>Coronaviruses</subject><subject>COVID-19</subject><subject>COVID-19 - complications</subject><subject>COVID-19 - mortality</subject><subject>COVID-19 - therapy</subject><subject>Data analysis</subject><subject>Drafting software</subject><subject>Editing</subject><subject>Engineering and Technology</subject><subject>Epidemiology</subject><subject>Female</subject><subject>Graduate schools</subject><subject>Graduate studies</subject><subject>Health aspects</subject><subject>Health care facilities</subject><subject>Humans</subject><subject>Hypertension - complications</subject><subject>Hypertension - drug therapy</subject><subject>Inhibitors</subject><subject>Male</subject><subject>Medicine</subject><subject>Medicine and Health Sciences</subject><subject>Middle Aged</subject><subject>Mortality</subject><subject>Patient outcomes</subject><subject>Prostate cancer</subject><subject>Public health</subject><subject>Renin</subject><subject>Renin inhibitors</subject><subject>Renin-angiotensin system</subject><subject>Renin-Angiotensin System - drug effects</subject><subject>Republic of Korea - epidemiology</subject><subject>Respiration, Artificial</subject><subject>Retrospective Studies</subject><subject>Social Sciences</subject><subject>Software</subject><subject>Stroke</subject><subject>Young Adult</subject><issn>1932-6203</issn><issn>1932-6203</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2021</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>BENPR</sourceid><sourceid>DOA</sourceid><recordid>eNqNkstu1DAUhiMEoqXwBggiISFYZPAldpINUlUVGFGpEtel5TjHMx5l7KntVPTtcTppNUFdoCxyZH__fy4-WfYSowWmFf6wcYO3sl_snIUFImWNWP0oO8YNJQUniD4-iI-yZyFsEGK05vxpdkRphVhZouPs97nWoGLudO7BGltIuzIugg1j3HcuRPApQx5uUrTNjV2b1kTnQ-5sfuauTVfgJt_JaMDGkO7zr86DfJ490bIP8GL6n2Q_P53_OPtSXFx-Xp6dXhSKNyQWhHHZEa05bjvKNYGqk2NlWOMGpWJpAx2jSFZlwxQpAfG6Ui1vWZlUNXB6kr3e--56F8Q0kyAIQ4hy3uA6Ecs90Tm5ETtvttLfCCeNuD1wfiWkj0b1IDrGW6Qk6wjWpUZ1o1QNUNMUaSVLlbw-TtmGdgudSi172c9M5zfWrMXKXYuqYXhfzLvJwLurAUIUWxMU9L204IbbujHhmNQj-uYf9OHuJmolUwPGapfyqtFUnHJWcsoYHqe0eIBKXwdbo9LzapPOZ4L3M0FiIvyJKzmEIJbfv_0_e_lrzr49YNcg-7gOrh-icTbMwXIPKu9C8KDvh4yRGPf_bhpi3H8x7X-SvTp8oHvR3cLTv2ym_6I</recordid><startdate>20210311</startdate><enddate>20210311</enddate><creator>Park, Jungchan</creator><creator>Lee, Seung-Hwa</creator><creator>You, Seng Chan</creator><creator>Kim, Jinseob</creator><creator>Yang, Kwangmo</creator><general>Public Library of Science</general><general>Public Library of Science (PLoS)</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>IOV</scope><scope>ISR</scope><scope>3V.</scope><scope>7QG</scope><scope>7QL</scope><scope>7QO</scope><scope>7RV</scope><scope>7SN</scope><scope>7SS</scope><scope>7T5</scope><scope>7TG</scope><scope>7TM</scope><scope>7U9</scope><scope>7X2</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8C1</scope><scope>8FD</scope><scope>8FE</scope><scope>8FG</scope><scope>8FH</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABJCF</scope><scope>ABUWG</scope><scope>AEUYN</scope><scope>AFKRA</scope><scope>ARAPS</scope><scope>ATCPS</scope><scope>AZQEC</scope><scope>BBNVY</scope><scope>BENPR</scope><scope>BGLVJ</scope><scope>BHPHI</scope><scope>C1K</scope><scope>CCPQU</scope><scope>D1I</scope><scope>DWQXO</scope><scope>FR3</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>H94</scope><scope>HCIFZ</scope><scope>K9.</scope><scope>KB.</scope><scope>KB0</scope><scope>KL.</scope><scope>L6V</scope><scope>LK8</scope><scope>M0K</scope><scope>M0S</scope><scope>M1P</scope><scope>M7N</scope><scope>M7P</scope><scope>M7S</scope><scope>NAPCQ</scope><scope>P5Z</scope><scope>P62</scope><scope>P64</scope><scope>PATMY</scope><scope>PDBOC</scope><scope>PIMPY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PTHSS</scope><scope>PYCSY</scope><scope>RC3</scope><scope>7X8</scope><scope>5PM</scope><scope>DOA</scope><orcidid>https://orcid.org/0000-0002-7794-3547</orcidid><orcidid>https://orcid.org/0000-0001-5508-7519</orcidid></search><sort><creationdate>20210311</creationdate><title>Effect of renin-angiotensin-aldosterone system inhibitors on Covid-19 patients in Korea</title><author>Park, Jungchan ; Lee, Seung-Hwa ; You, Seng Chan ; Kim, Jinseob ; Yang, Kwangmo</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c692t-256ad2ff61bd36f2e7da05441f19038639ed530a7495c24e0687cb6b54d2f8e63</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2021</creationdate><topic>ACE inhibitors</topic><topic>Adolescent</topic><topic>Adult</topic><topic>Aged</topic><topic>Aldosterone</topic><topic>Angiotensin</topic><topic>Angiotensin Receptor Antagonists - therapeutic use</topic><topic>Angiotensin-Converting Enzyme Inhibitors - therapeutic use</topic><topic>Antihypertensive agents</topic><topic>Antihypertensive Agents - therapeutic use</topic><topic>Antihypertensives</topic><topic>Authoring</topic><topic>Bladder cancer</topic><topic>Cardiology</topic><topic>Computer programs</topic><topic>Confidence intervals</topic><topic>Coronaviruses</topic><topic>COVID-19</topic><topic>COVID-19 - complications</topic><topic>COVID-19 - mortality</topic><topic>COVID-19 - therapy</topic><topic>Data analysis</topic><topic>Drafting software</topic><topic>Editing</topic><topic>Engineering and Technology</topic><topic>Epidemiology</topic><topic>Female</topic><topic>Graduate schools</topic><topic>Graduate studies</topic><topic>Health aspects</topic><topic>Health care facilities</topic><topic>Humans</topic><topic>Hypertension - complications</topic><topic>Hypertension - drug therapy</topic><topic>Inhibitors</topic><topic>Male</topic><topic>Medicine</topic><topic>Medicine and Health Sciences</topic><topic>Middle Aged</topic><topic>Mortality</topic><topic>Patient outcomes</topic><topic>Prostate cancer</topic><topic>Public health</topic><topic>Renin</topic><topic>Renin inhibitors</topic><topic>Renin-angiotensin system</topic><topic>Renin-Angiotensin System - 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Academic</collection><collection>PubMed Central (Full Participant titles)</collection><collection>DOAJ Directory of Open Access Journals</collection><jtitle>PloS one</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Park, Jungchan</au><au>Lee, Seung-Hwa</au><au>You, Seng Chan</au><au>Kim, Jinseob</au><au>Yang, Kwangmo</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Effect of renin-angiotensin-aldosterone system inhibitors on Covid-19 patients in Korea</atitle><jtitle>PloS one</jtitle><addtitle>PLoS One</addtitle><date>2021-03-11</date><risdate>2021</risdate><volume>16</volume><issue>3</issue><spage>e0248058</spage><epage>e0248058</epage><pages>e0248058-e0248058</pages><issn>1932-6203</issn><eissn>1932-6203</eissn><abstract>The effect of renin-angiotensin-aldosterone system (RAAS) inhibitors in coronavirus disease 19 (Covid-19) patients has not been fully investigated. We evaluated the association between RAAS inhibitor use and outcomes of Covid-19.
This study was a retrospective observational cohort study that used data based on insurance benefit claims sent to the Health Insurance Review and Assessment Service of Korea by May 15, 2020. These claims comprised all Covid-19 tested cases and the history of medical service use in these patients for the past five years. The primary outcome was all-cause mortality, and the rate of ventilator care was compared between the groups.
From a total of 7,590 patients diagnosed with Covid-19, two distinct cohorts were generated based on RAAS inhibitors prescribed within 6 months before Covid-19 diagnosis. A total of 1,111 patients was prescribed RAAS inhibitors, and 794 patients were prescribed antihypertensive drugs, excluding RAAS inhibitors. In propensity-score matched analysis, 666 pairs of data set were generated, and all-cause mortality of the RAAS inhibitor group showed no significant difference compared with the non-RAAS inhibitor group (14.6% vs. 11.1%; hazard ratio [HR], 0.79; 95% confidence interval [CI], 0.54-1.15; p = 0.22). The rate of ventilator care was not significantly different between the two groups (4.4% vs. 4.1%; HR, 1.04; 95%CI, 0.60-1.79; p = 0.89).
RAAS inhibitor treatment did not appear to increase the mortality of Covid-19 patients compared with other antihypertensive drugs, suggesting that they may be safely continued in Covid-19 patients.</abstract><cop>United States</cop><pub>Public Library of Science</pub><pmid>33705440</pmid><doi>10.1371/journal.pone.0248058</doi><tpages>e0248058</tpages><orcidid>https://orcid.org/0000-0002-7794-3547</orcidid><orcidid>https://orcid.org/0000-0001-5508-7519</orcidid><oa>free_for_read</oa></addata></record> |
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| ispartof | PloS one, 2021-03, Vol.16 (3), p.e0248058-e0248058 |
| issn | 1932-6203 1932-6203 |
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| source | Public Library of Science (PLoS) Journals Open Access; MEDLINE; DOAJ Directory of Open Access Journals; EZB-FREE-00999 freely available EZB journals; PubMed Central; Free Full-Text Journals in Chemistry |
| subjects | ACE inhibitors Adolescent Adult Aged Aldosterone Angiotensin Angiotensin Receptor Antagonists - therapeutic use Angiotensin-Converting Enzyme Inhibitors - therapeutic use Antihypertensive agents Antihypertensive Agents - therapeutic use Antihypertensives Authoring Bladder cancer Cardiology Computer programs Confidence intervals Coronaviruses COVID-19 COVID-19 - complications COVID-19 - mortality COVID-19 - therapy Data analysis Drafting software Editing Engineering and Technology Epidemiology Female Graduate schools Graduate studies Health aspects Health care facilities Humans Hypertension - complications Hypertension - drug therapy Inhibitors Male Medicine Medicine and Health Sciences Middle Aged Mortality Patient outcomes Prostate cancer Public health Renin Renin inhibitors Renin-angiotensin system Renin-Angiotensin System - drug effects Republic of Korea - epidemiology Respiration, Artificial Retrospective Studies Social Sciences Software Stroke Young Adult |
| title | Effect of renin-angiotensin-aldosterone system inhibitors on Covid-19 patients in Korea |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-02-12T13%3A04%3A28IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-gale_plos_&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Effect%20of%20renin-angiotensin-aldosterone%20system%20inhibitors%20on%20Covid-19%20patients%20in%20Korea&rft.jtitle=PloS%20one&rft.au=Park,%20Jungchan&rft.date=2021-03-11&rft.volume=16&rft.issue=3&rft.spage=e0248058&rft.epage=e0248058&rft.pages=e0248058-e0248058&rft.issn=1932-6203&rft.eissn=1932-6203&rft_id=info:doi/10.1371/journal.pone.0248058&rft_dat=%3Cgale_plos_%3EA654635516%3C/gale_plos_%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=2500366918&rft_id=info:pmid/33705440&rft_galeid=A654635516&rft_doaj_id=oai_doaj_org_article_d56b0ca5d21f4f089cc8ee83089fca4c&rfr_iscdi=true |