Risk of infection or severe COVID-19 disease and association with antihypertensive medications

May 15, 2020

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The authors were interested in whether this is an increased risk in patients with COVID-19 due to medications that act on the renin-angiotensin-aldosterone system. They examined the relationship between previous treatment with ACE inhibitors, angiotensin-receptor blockers, beta-blockers, calcium-channel blockers or thiazide diuretics and the likelihood of a positive or negative result upon SARS-CoV-2 testing, as well as the likelihood of severe disease (intensive care, mechanical ventilation or death) among patients who test positive. 12,594 patients were tested for SARS-CoV-2, 46.8% of whom were positive. Of these 17.0% had severe disease. The authors found that a history of hypertension was present in 34.6% of patients, among whom 59.1% had a positive test and 24.6% of these had severe disease. There was no association seen between any single medication class and an increased likelihood of a positive test. None of the medications was associated with an increase in the risk of severe disease. Therefore there does not appear to be an increase in the likelihood of a positive test for COVID-19 or risk of severe disease in association with five common classes of antihypertensive medications.

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Reynolds HR, Adhikari S, Pulgarin C, Troxel AB, Iturrate E, et al. ISSN: N Engl J Med; doi: 10.1056/NEJMoa2008975


Added: May 15, 2020