The Effect of Angiotensin-Converting Enzyme Inhibitor and Angiotensin Receptor Blocker on the Outcome of Hospitalization of Patients With Hypertension and COVID-19

Background To study the effect of angiotensin-converting enzyme inhibitor (ACEI) and angiotensin receptor blocker (ARB) on the outcome of hospitalization in patients with hypertension and novel coronavirus disease 2019 (COVID-19). Methods A retrospective analysis was performed in 202 COVID-19 patients who were hospitalized in Thunder-God Hospital, Wuhan from 12 February 2020 to 30 March 2020. According to whether taking ACEI or ARB, 67 (33.0%) patients with hypertension were divided into 3 groups: A, patients received ACEI or ARB after admission (n = 22); B, patients received ACEI or ARB before admission but interrupted after admission (n = 24); and C, patients were not treated with ACEI or ARB before or after admission (n = 21). Changes of therapeutic indicators in all groups of patients and their application relationship with ACEI/ARB were compared and analyzed. Results There were no significant differences in age, gender, blood pressure, underlying disease severity, or serum biochemical indicators (ALT, LDH, creatinine, and creatine kinase levels) at admission among 3 groups (all P > 0.05). During hospitalization, there were no significant differences in COVID-19-related treatment, oxygen use, hospital mortality, recovery and discharge rate, or days of throat swab nucleic acid turning negative among 3 groups (all P > 0.05). The proportion of calcium channel blocker in groups B and C was higher than group A (95.8% and 85.7% vs. 40.9%, P < 0.01), but there was no significant difference in blood pressure or compliance rates at discharge (P > 0.05). Group A, B, and C patients were hospitalized for 27.4 ± 6.4, 30.0 ± 8.8, and 30.1 ± 9.3 days, respectively (all P > 0.05). Compared with admission values, there were no significant differences in serum ALT, LDH, creatinine, or creatine kinase levels among all 3 groups during hospitalization (all P > 0.05). Conclusions ACEI or ARB has no significant effect on the outcome of hospitalization in patients with hypertension and COVID-19.