Angiotensin Receptor Blockers and Angiotensin-Converting Enzyme Inhibitors in COVID-19: Meta-analysis/Meta-regression Adjusted for Confounding Factors
- Terry Lee, PhD
- Alessandro Cau, BSc
- Matthew Pellan Cheng, MD
- Adeera Levin, MD
- Todd C. Lee, MD
- Donald C. Vinh, MD
- Francois Lamontagne, MD
- Joel Singer, PhD
- Keith R. Walley, MD
- Srinivas Murthy, MD
- David Patrick, MD
- Oleksa G. Rewa, MD
- Brent W. Winston, MD
- John Marshall, MD
- John Boyd, MD
- Karen Tran, MD
- Andre C. Kalil, MD
- Russell Mcculoh, MD
- Robert Fowler, MD
- James M. Luther, MD
- James A. Russell, MD
DOIAbstract
Background: Angiotensin receptor blockers (ARBs) and/or angiotensin-converting enzyme (ACE) inhibitors could alter mortality from coronavirus disease 2019 (COVID-19), but existing meta-analyses that combined crude and adjusted results may be confounded by the fact that comorbidities are more common in ARB/ACE inhibitor users. Methods: We searched PubMed/MEDLINE/Embase for cohort studies and meta-analyses reporting mortality by preexisting ARB/ACE inhibitor treatment in hospitalized COVID-19 patients. Random effects meta-regression was used to compute pooled odds ratios for mortality adjusted for imbalance in age, sex, and prevalence of cardiovascular disease, hypertension, diabetes mellitus, and chronic kidney disease between users and nonu...
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