META-ANALYSIS OF SAFETY AND EFFICACY OF RENIN ANGIOTENSIN ALDOSTERONE SYSTEM INHIBITORS IN COVID-19 POPULATION

Sattar, Yasar; Mukuntharaj, Pradeeksha; Attique, Hassan; Ullah, Waqas; Sana, Muhammad Khawar; Zaher, Nathan; Suleiman, Abdul-Rahman M.; Mehmood, Maham; Panchal, Ankur; Mir, Tanveer; Nadeem, Muhammad; Zghouzi, Mohamed; Ahmad, Bachar; Hakim, Zaher; Gardi, Delair; Ali, Omar E.; Alhatemi, Ghaith; Mohamed, Mohamad; Elgendy, Islam; Mamas, Mamas; Alraies, M. Chadi

Abstract

Background
The safety and efficacy of Renin Angiotensin Aldosterone System Inhibitors(RAASi) in COVID 19 patients has been controversial.

Methods
Digital databases were queried for relevant articles. A random-effect model was used to compute an unadjusted odds ratio (OR).

Results
A total of 49 studies were included in the analysis yielding 82,610 COVID-19 patients (RAASi n=34357; No RAASi n=48253). The mean age was 64 years old and 57% of the sample was male. RAASi has similar mortality outcomes as compared to the non-RAASi group (OR-1.07; 95% CI: 0.74-1.15; p-0.08) (Figure 1). Significant improvements in seroconversion, including negative RT-PCR was found with RAASi (OR-0.96; 95% CI 0.93-0.99; p-0.02). Patients with RAASi can have higher in-hospital admission requirements (OR-1.12; 95% CI 1.04-1.21; p-0.004). We also found non-significant associations of RAASi with improvement in progression to ICU admission (OR- 0.99; 95% CI 0.79-1.23; p-0.9) and higher odds of worsening of clinical manifestations (OR-1.04; 95% CI 0.97-1.11; p-0.2) as compared to the absence of RAASi (Figure 1).

Conclusion
RAASi could be considered safe in patients with COVID-19. A continuation of RAASi can bring favorable outcomes including seropositivity/viral clearance and less inpatient hospitalization.

Citation

Sattar, Y., Mukuntharaj, P., Attique, H., Ullah, W., Sana, M. K., Zaher, N., Suleiman, A.-R. M., Mehmood, M., Panchal, A., Mir, T., Nadeem, M., Zghouzi, M., Ahmad, B., Hakim, Z., Gardi, D., Ali, O. E., Alhatemi, G., Mohamed, M., Elgendy, I., Mamas, M., & Alraies, M. C. META-ANALYSIS OF SAFETY AND EFFICACY OF RENIN ANGIOTENSIN ALDOSTERONE SYSTEM INHIBITORS IN COVID-19 POPULATION. Presented at ACC.21

• Presentation Conference Type: Conference Paper (published)
• Conference Name: ACC.21
• Acceptance Date: May 3, 2021
• Online Publication Date: May 3, 2021
• Publication Date: May 11, 2021
• Deposit Date: Jun 23, 2023
• Journal: Journal of the American College of Cardiology
• Print ISSN: 0735-1097
• Electronic ISSN: 1558-3597
• Publisher: Elsevier
• Peer Reviewed: Peer Reviewed
• Volume: 77
• Issue: 18 S1
• Pages: 3158
• DOI: https://doi.org/10.1016/s0735-1097%2821%2904513-7
• Keywords: Cardiology and Cardiovascular Medicine
• Public URL: https://keele-repository.worktribe.com/output/504216