SARS-CoV-2 infection and adverse outcomes in users of ACE inhibitors and angiotensin-receptor blockers: a nationwide case-control and cohort analysis.
Identifieur interne : 000294 ( Main/Exploration ); précédent : 000293; suivant : 000295SARS-CoV-2 infection and adverse outcomes in users of ACE inhibitors and angiotensin-receptor blockers: a nationwide case-control and cohort analysis.
Auteurs : Christian Fynbo Christiansen [Danemark] ; Anton Potteg Rd [Danemark] ; Uffe Heide-J Rgensen [Danemark] ; Jacob Bodilsen [Danemark] ; Ole Schmeltz S Gaard [Danemark] ; Michael Maeng [Danemark] ; Simon Tilma Vistisen [Danemark] ; Morten Schmidt [Danemark] ; Lars Christian Lund [Danemark] ; Mette Reilev [Danemark] ; Jesper Hallas [Danemark] ; Marianne Voldstedlund [Danemark] ; Anders Husby [Danemark] ; Marianne Kragh Thomsen [Danemark] ; Nanna Borup Johansen [Danemark] ; Nikolai Constantin Brun [Danemark] ; Reimar Wernich Thomsen [Danemark] ; Hans Erik B Tker [Danemark] ; Henrik Toft S Rensen [Danemark, États-Unis]Source :
- Thorax [ 1468-3296 ] ; 2020.
Abstract
OBJECTIVE
To examine the impact of ACE inhibitor (ACE-I)/angiotensin receptor blocker (ARB) use on rate of SARS-CoV-2 infection and adverse outcomes.
METHODS
This nationwide case-control and cohort study included all individuals in Denmark tested for SARS-CoV-2 RNA with PCR from 27 February 2020 to 26 July 2020. We estimated confounder-adjusted ORs for a positive test among all SARS-CoV-2 tested, and inverse probability of treatment weighted 30-day risk and risk ratios (RRs) of hospitalisation, intensive care unit (ICU) admission and mortality comparing current ACE-I/ARB use with calcium channel blocker (CCB) use and with non-use.
RESULTS
The study included 13 501 SARS-CoV-2 PCR-positive and 1 088 695 PCR-negative individuals. Users of ACE-I/ARB had a marginally increased rate of a positive PCR when compared with CCB users (aOR 1.17, 95% CI 1.00 to 1.37), but not when compared with non-users (aOR 1.00 95% CI 0.92 to 1.09).Among PCR-positive individuals, 1466 (11%) were ACE-I/ARB users. The weighted risk of hospitalisation was 36.5% in ACE-I/ARB users and 43.3% in CCB users (RR 0.84, 95% CI 0.70 to 1.02). The risk of ICU admission was 6.3% in ACE-I/ARB users and 5.4% in CCB users (RR 1.17, 95% CI 0.64 to 2.16), while the 30-day mortality was 12.3% in ACE-I/ARB users and 13.9% in CCB users (RR 0.89, 95% CI 0.61 to 1.30). The associations were similar when ACE-I/ARB users were compared with non-users.
CONCLUSIONS
ACE-I/ARB use was associated neither with a consistently increased rate nor with adverse outcomes of SARS-CoV-2 infection. Our findings support the current recommendation of continuing use of ACE-Is/ARBs during the SARS-CoV-2 pandemic.
TRIAL REGISTRATION NUMBER
EUPAS34887.
DOI: 10.1136/thoraxjnl-2020-215768
PubMed: 33293279
PubMed Central: PMC7725106
Affiliations:
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Pharmacology, Pharmacy and Environmental Medicine, Department of Public Health, University of Southern Denmark, Odense C, Denmark.</nlm:affiliation><country xml:lang="fr">Danemark</country><wicri:regionArea>Clinical Pharmacology, Pharmacy and Environmental Medicine, Department of Public Health, University of Southern Denmark, Odense C</wicri:regionArea><wicri:noRegion>Odense C</wicri:noRegion></affiliation></author><author><name sortKey="Heide J Rgensen, Uffe" sort="Heide J Rgensen, Uffe" uniqKey="Heide J Rgensen U" first="Uffe" last="Heide-J Rgensen">Uffe Heide-J Rgensen</name><affiliation wicri:level="1"><nlm:affiliation>Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus N, Denmark.</nlm:affiliation><country xml:lang="fr">Danemark</country><wicri:regionArea>Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus N</wicri:regionArea><wicri:noRegion>Aarhus N</wicri:noRegion></affiliation></author><author><name sortKey="Bodilsen, Jacob" 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Aarhus University Hospital, Aarhus N, Denmark.</nlm:affiliation><country xml:lang="fr">Danemark</country><wicri:regionArea>Department of Intensive Care, Aarhus University Hospital, Aarhus N</wicri:regionArea><wicri:noRegion>Aarhus N</wicri:noRegion></affiliation></author><author><name sortKey="Schmidt, Morten" sort="Schmidt, Morten" uniqKey="Schmidt M" first="Morten" last="Schmidt">Morten Schmidt</name><affiliation wicri:level="1"><nlm:affiliation>Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus N, Denmark.</nlm:affiliation><country xml:lang="fr">Danemark</country><wicri:regionArea>Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus N</wicri:regionArea><wicri:noRegion>Aarhus N</wicri:noRegion></affiliation><affiliation wicri:level="1"><nlm:affiliation>Department of Cardiology, Aarhus University Hospital, Aarhus N, Denmark.</nlm:affiliation><country xml:lang="fr">Danemark</country><wicri:regionArea>Department of Cardiology, Aarhus University Hospital, Aarhus N</wicri:regionArea><wicri:noRegion>Aarhus N</wicri:noRegion></affiliation><affiliation wicri:level="1"><nlm:affiliation>Department of Cardiology, Regional Hospital West Jutland, Herning, Denmark.</nlm:affiliation><country xml:lang="fr">Danemark</country><wicri:regionArea>Department of Cardiology, Regional Hospital West Jutland, Herning</wicri:regionArea><wicri:noRegion>Herning</wicri:noRegion></affiliation></author><author><name sortKey="Lund, Lars Christian" sort="Lund, Lars Christian" uniqKey="Lund L" first="Lars Christian" last="Lund">Lars Christian Lund</name><affiliation wicri:level="1"><nlm:affiliation>Clinical Pharmacology, Pharmacy and Environmental Medicine, Department of Public Health, University of Southern Denmark, Odense C, Denmark.</nlm:affiliation><country xml:lang="fr">Danemark</country><wicri:regionArea>Clinical Pharmacology, Pharmacy and Environmental Medicine, Department of Public Health, University of Southern Denmark, Odense C</wicri:regionArea><wicri:noRegion>Odense C</wicri:noRegion></affiliation></author><author><name sortKey="Reilev, Mette" sort="Reilev, Mette" uniqKey="Reilev M" first="Mette" last="Reilev">Mette Reilev</name><affiliation wicri:level="1"><nlm:affiliation>Clinical Pharmacology, Pharmacy and Environmental Medicine, Department of Public Health, University of Southern Denmark, Odense C, Denmark.</nlm:affiliation><country xml:lang="fr">Danemark</country><wicri:regionArea>Clinical Pharmacology, Pharmacy and Environmental Medicine, Department of Public Health, University of Southern Denmark, Odense C</wicri:regionArea><wicri:noRegion>Odense C</wicri:noRegion></affiliation></author><author><name sortKey="Hallas, Jesper" sort="Hallas, Jesper" uniqKey="Hallas J" first="Jesper" last="Hallas">Jesper Hallas</name><affiliation wicri:level="1"><nlm:affiliation>Clinical Pharmacology, Pharmacy and Environmental Medicine, Department of Public Health, University of Southern Denmark, Odense C, Denmark.</nlm:affiliation><country xml:lang="fr">Danemark</country><wicri:regionArea>Clinical Pharmacology, Pharmacy and Environmental Medicine, Department of Public Health, University of Southern Denmark, Odense C</wicri:regionArea><wicri:noRegion>Odense C</wicri:noRegion></affiliation></author><author><name sortKey="Voldstedlund, Marianne" sort="Voldstedlund, Marianne" uniqKey="Voldstedlund M" first="Marianne" last="Voldstedlund">Marianne Voldstedlund</name><affiliation wicri:level="1"><nlm:affiliation>Department of Data Integration and Analysis, Statens Serum Institut, Copenhagen S, Denmark.</nlm:affiliation><country xml:lang="fr">Danemark</country><wicri:regionArea>Department of Data Integration and Analysis, Statens Serum Institut, Copenhagen S</wicri:regionArea><wicri:noRegion>Copenhagen S</wicri:noRegion></affiliation></author><author><name sortKey="Husby, Anders" sort="Husby, Anders" uniqKey="Husby A" first="Anders" last="Husby">Anders Husby</name><affiliation wicri:level="1"><nlm:affiliation>Department of Epidemiology Research, Statens Serum Institut, Copenhagen S, Denmark.</nlm:affiliation><country xml:lang="fr">Danemark</country><wicri:regionArea>Department of Epidemiology Research, Statens Serum Institut, Copenhagen S</wicri:regionArea><wicri:noRegion>Copenhagen S</wicri:noRegion></affiliation></author><author><name sortKey="Thomsen, Marianne Kragh" sort="Thomsen, Marianne Kragh" uniqKey="Thomsen M" first="Marianne Kragh" last="Thomsen">Marianne Kragh Thomsen</name><affiliation wicri:level="1"><nlm:affiliation>Department of Clinical Microbiology, Aarhus University Hospital, Aarhus N, Denmark.</nlm:affiliation><country xml:lang="fr">Danemark</country><wicri:regionArea>Department of Clinical Microbiology, Aarhus University Hospital, Aarhus N</wicri:regionArea><wicri:noRegion>Aarhus N</wicri:noRegion></affiliation></author><author><name sortKey="Johansen, Nanna Borup" sort="Johansen, Nanna Borup" uniqKey="Johansen N" first="Nanna Borup" last="Johansen">Nanna Borup Johansen</name><affiliation wicri:level="1"><nlm:affiliation>Department of Medical Evaluation and Biostatistics, Danish Medicines Agency, Copenhagen S, Denmark.</nlm:affiliation><country xml:lang="fr">Danemark</country><wicri:regionArea>Department of Medical Evaluation and Biostatistics, Danish Medicines Agency, Copenhagen S</wicri:regionArea><wicri:noRegion>Copenhagen S</wicri:noRegion></affiliation></author><author><name sortKey="Brun, Nikolai Constantin" sort="Brun, Nikolai Constantin" uniqKey="Brun N" first="Nikolai Constantin" last="Brun">Nikolai Constantin Brun</name><affiliation wicri:level="1"><nlm:affiliation>Department of Medical Evaluation and Biostatistics, Danish Medicines Agency, Copenhagen S, Denmark.</nlm:affiliation><country xml:lang="fr">Danemark</country><wicri:regionArea>Department of Medical Evaluation and Biostatistics, Danish Medicines Agency, Copenhagen S</wicri:regionArea><wicri:noRegion>Copenhagen S</wicri:noRegion></affiliation></author><author><name sortKey="Thomsen, Reimar Wernich" sort="Thomsen, Reimar Wernich" uniqKey="Thomsen R" first="Reimar Wernich" last="Thomsen">Reimar Wernich Thomsen</name><affiliation wicri:level="1"><nlm:affiliation>Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus N, Denmark.</nlm:affiliation><country xml:lang="fr">Danemark</country><wicri:regionArea>Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus N</wicri:regionArea><wicri:noRegion>Aarhus N</wicri:noRegion></affiliation></author><author><name sortKey="B Tker, Hans Erik" sort="B Tker, Hans Erik" uniqKey="B Tker H" first="Hans Erik" last="B Tker">Hans Erik B Tker</name><affiliation wicri:level="1"><nlm:affiliation>Department of Cardiology, Aarhus University Hospital, Aarhus N, Denmark.</nlm:affiliation><country xml:lang="fr">Danemark</country><wicri:regionArea>Department of Cardiology, Aarhus University Hospital, Aarhus N</wicri:regionArea><wicri:noRegion>Aarhus N</wicri:noRegion></affiliation></author><author><name sortKey="S Rensen, Henrik Toft" sort="S Rensen, Henrik Toft" uniqKey="S Rensen H" first="Henrik Toft" last="S Rensen">Henrik Toft S Rensen</name><affiliation wicri:level="1"><nlm:affiliation>Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus N, Denmark.</nlm:affiliation><country xml:lang="fr">Danemark</country><wicri:regionArea>Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus N</wicri:regionArea><wicri:noRegion>Aarhus N</wicri:noRegion></affiliation><affiliation wicri:level="4"><nlm:affiliation>Center for Population Health Sciences, Stanford University, Stanford, California, USA.</nlm:affiliation><country xml:lang="fr">États-Unis</country><wicri:regionArea>Center for Population Health Sciences, Stanford University, Stanford, California</wicri:regionArea><placeName><region type="state">Californie</region><settlement type="city">Stanford 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sort="Christiansen, Christian Fynbo" uniqKey="Christiansen C" first="Christian Fynbo" last="Christiansen">Christian Fynbo Christiansen</name><affiliation wicri:level="1"><nlm:affiliation>Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus N, Denmark cfc@clin.au.dk.</nlm:affiliation><country wicri:rule="url">Danemark</country><wicri:regionArea>Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus N</wicri:regionArea><wicri:noRegion>Aarhus N</wicri:noRegion></affiliation></author><author><name sortKey="Potteg Rd, Anton" sort="Potteg Rd, Anton" uniqKey="Potteg Rd A" first="Anton" last="Potteg Rd">Anton Potteg Rd</name><affiliation wicri:level="1"><nlm:affiliation>Clinical Pharmacology, Pharmacy and Environmental Medicine, Department of Public Health, University of Southern Denmark, Odense C, Denmark.</nlm:affiliation><country xml:lang="fr">Danemark</country><wicri:regionArea>Clinical Pharmacology, Pharmacy and Environmental Medicine, Department of Public Health, University of Southern Denmark, Odense C</wicri:regionArea><wicri:noRegion>Odense C</wicri:noRegion></affiliation></author><author><name sortKey="Heide J Rgensen, Uffe" sort="Heide J Rgensen, Uffe" uniqKey="Heide J Rgensen U" first="Uffe" last="Heide-J Rgensen">Uffe Heide-J Rgensen</name><affiliation wicri:level="1"><nlm:affiliation>Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus N, Denmark.</nlm:affiliation><country xml:lang="fr">Danemark</country><wicri:regionArea>Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus N</wicri:regionArea><wicri:noRegion>Aarhus N</wicri:noRegion></affiliation></author><author><name sortKey="Bodilsen, Jacob" sort="Bodilsen, Jacob" uniqKey="Bodilsen J" first="Jacob" last="Bodilsen">Jacob Bodilsen</name><affiliation wicri:level="1"><nlm:affiliation>Department of Infectious Diseases, Aalborg University Hospital, Aalborg, Denmark.</nlm:affiliation><country xml:lang="fr">Danemark</country><wicri:regionArea>Department of Infectious Diseases, Aalborg University Hospital, Aalborg</wicri:regionArea><wicri:noRegion>Aalborg</wicri:noRegion></affiliation></author><author><name sortKey="S Gaard, Ole Schmeltz" sort="S Gaard, Ole Schmeltz" uniqKey="S Gaard O" first="Ole Schmeltz" last="S Gaard">Ole Schmeltz S Gaard</name><affiliation wicri:level="1"><nlm:affiliation>Department of Infectious Diseases, Aarhus University Hospital, Aarhus N, Denmark.</nlm:affiliation><country xml:lang="fr">Danemark</country><wicri:regionArea>Department of Infectious Diseases, Aarhus University Hospital, Aarhus N</wicri:regionArea><wicri:noRegion>Aarhus N</wicri:noRegion></affiliation></author><author><name sortKey="Maeng, Michael" sort="Maeng, Michael" uniqKey="Maeng M" first="Michael" last="Maeng">Michael Maeng</name><affiliation wicri:level="1"><nlm:affiliation>Department of Cardiology, Aarhus University Hospital, Aarhus N, Denmark.</nlm:affiliation><country xml:lang="fr">Danemark</country><wicri:regionArea>Department of Cardiology, Aarhus University Hospital, Aarhus N</wicri:regionArea><wicri:noRegion>Aarhus N</wicri:noRegion></affiliation></author><author><name sortKey="Vistisen, Simon Tilma" sort="Vistisen, Simon Tilma" uniqKey="Vistisen S" first="Simon Tilma" last="Vistisen">Simon Tilma Vistisen</name><affiliation wicri:level="1"><nlm:affiliation>Department of Clinical Medicine, Aarhus University, Aarhus N, Denmark.</nlm:affiliation><country xml:lang="fr">Danemark</country><wicri:regionArea>Department of Clinical Medicine, Aarhus University, Aarhus N</wicri:regionArea><wicri:noRegion>Aarhus N</wicri:noRegion></affiliation><affiliation wicri:level="1"><nlm:affiliation>Department of Intensive Care, Aarhus University Hospital, Aarhus N, Denmark.</nlm:affiliation><country xml:lang="fr">Danemark</country><wicri:regionArea>Department of Intensive Care, Aarhus University Hospital, Aarhus N</wicri:regionArea><wicri:noRegion>Aarhus N</wicri:noRegion></affiliation></author><author><name sortKey="Schmidt, Morten" sort="Schmidt, Morten" uniqKey="Schmidt M" first="Morten" last="Schmidt">Morten Schmidt</name><affiliation wicri:level="1"><nlm:affiliation>Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus N, Denmark.</nlm:affiliation><country xml:lang="fr">Danemark</country><wicri:regionArea>Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus N</wicri:regionArea><wicri:noRegion>Aarhus N</wicri:noRegion></affiliation><affiliation wicri:level="1"><nlm:affiliation>Department of Cardiology, Aarhus University Hospital, Aarhus N, Denmark.</nlm:affiliation><country xml:lang="fr">Danemark</country><wicri:regionArea>Department of Cardiology, Aarhus University Hospital, Aarhus N</wicri:regionArea><wicri:noRegion>Aarhus N</wicri:noRegion></affiliation><affiliation wicri:level="1"><nlm:affiliation>Department of Cardiology, Regional Hospital West Jutland, Herning, Denmark.</nlm:affiliation><country xml:lang="fr">Danemark</country><wicri:regionArea>Department of Cardiology, Regional Hospital West Jutland, Herning</wicri:regionArea><wicri:noRegion>Herning</wicri:noRegion></affiliation></author><author><name sortKey="Lund, Lars Christian" sort="Lund, Lars Christian" uniqKey="Lund L" first="Lars Christian" last="Lund">Lars Christian Lund</name><affiliation wicri:level="1"><nlm:affiliation>Clinical Pharmacology, Pharmacy and Environmental Medicine, Department of Public Health, University of Southern Denmark, Odense C, Denmark.</nlm:affiliation><country xml:lang="fr">Danemark</country><wicri:regionArea>Clinical Pharmacology, Pharmacy and Environmental Medicine, Department of Public Health, University of Southern Denmark, Odense C</wicri:regionArea><wicri:noRegion>Odense C</wicri:noRegion></affiliation></author><author><name sortKey="Reilev, Mette" sort="Reilev, Mette" uniqKey="Reilev M" first="Mette" last="Reilev">Mette Reilev</name><affiliation wicri:level="1"><nlm:affiliation>Clinical Pharmacology, Pharmacy and Environmental Medicine, Department of Public Health, University of Southern Denmark, Odense C, Denmark.</nlm:affiliation><country xml:lang="fr">Danemark</country><wicri:regionArea>Clinical Pharmacology, Pharmacy and Environmental Medicine, Department of Public Health, University of Southern Denmark, Odense C</wicri:regionArea><wicri:noRegion>Odense C</wicri:noRegion></affiliation></author><author><name sortKey="Hallas, Jesper" sort="Hallas, Jesper" uniqKey="Hallas J" first="Jesper" last="Hallas">Jesper Hallas</name><affiliation wicri:level="1"><nlm:affiliation>Clinical Pharmacology, Pharmacy and Environmental Medicine, Department of Public Health, University of Southern Denmark, Odense C, Denmark.</nlm:affiliation><country xml:lang="fr">Danemark</country><wicri:regionArea>Clinical Pharmacology, Pharmacy and Environmental Medicine, Department of Public Health, University of Southern Denmark, Odense C</wicri:regionArea><wicri:noRegion>Odense C</wicri:noRegion></affiliation></author><author><name sortKey="Voldstedlund, Marianne" sort="Voldstedlund, Marianne" uniqKey="Voldstedlund M" first="Marianne" last="Voldstedlund">Marianne Voldstedlund</name><affiliation wicri:level="1"><nlm:affiliation>Department of Data Integration and Analysis, Statens Serum Institut, Copenhagen S, Denmark.</nlm:affiliation><country xml:lang="fr">Danemark</country><wicri:regionArea>Department of Data Integration and Analysis, Statens Serum Institut, Copenhagen S</wicri:regionArea><wicri:noRegion>Copenhagen S</wicri:noRegion></affiliation></author><author><name sortKey="Husby, Anders" sort="Husby, Anders" uniqKey="Husby A" first="Anders" last="Husby">Anders Husby</name><affiliation wicri:level="1"><nlm:affiliation>Department of Epidemiology Research, Statens Serum Institut, Copenhagen S, Denmark.</nlm:affiliation><country xml:lang="fr">Danemark</country><wicri:regionArea>Department of Epidemiology Research, Statens Serum Institut, Copenhagen S</wicri:regionArea><wicri:noRegion>Copenhagen S</wicri:noRegion></affiliation></author><author><name sortKey="Thomsen, Marianne Kragh" sort="Thomsen, Marianne Kragh" uniqKey="Thomsen M" first="Marianne Kragh" last="Thomsen">Marianne Kragh Thomsen</name><affiliation wicri:level="1"><nlm:affiliation>Department of Clinical Microbiology, Aarhus University Hospital, Aarhus N, Denmark.</nlm:affiliation><country xml:lang="fr">Danemark</country><wicri:regionArea>Department of Clinical Microbiology, Aarhus University Hospital, Aarhus N</wicri:regionArea><wicri:noRegion>Aarhus N</wicri:noRegion></affiliation></author><author><name sortKey="Johansen, Nanna Borup" sort="Johansen, Nanna Borup" uniqKey="Johansen N" first="Nanna Borup" last="Johansen">Nanna Borup Johansen</name><affiliation wicri:level="1"><nlm:affiliation>Department of Medical Evaluation and Biostatistics, Danish Medicines Agency, Copenhagen S, Denmark.</nlm:affiliation><country xml:lang="fr">Danemark</country><wicri:regionArea>Department of Medical Evaluation and Biostatistics, Danish Medicines Agency, Copenhagen S</wicri:regionArea><wicri:noRegion>Copenhagen S</wicri:noRegion></affiliation></author><author><name sortKey="Brun, Nikolai Constantin" sort="Brun, Nikolai Constantin" uniqKey="Brun N" first="Nikolai Constantin" last="Brun">Nikolai Constantin Brun</name><affiliation wicri:level="1"><nlm:affiliation>Department of Medical Evaluation and Biostatistics, Danish Medicines Agency, Copenhagen S, Denmark.</nlm:affiliation><country xml:lang="fr">Danemark</country><wicri:regionArea>Department of Medical Evaluation and Biostatistics, Danish Medicines Agency, Copenhagen S</wicri:regionArea><wicri:noRegion>Copenhagen S</wicri:noRegion></affiliation></author><author><name sortKey="Thomsen, Reimar Wernich" sort="Thomsen, Reimar Wernich" uniqKey="Thomsen R" first="Reimar Wernich" last="Thomsen">Reimar Wernich Thomsen</name><affiliation wicri:level="1"><nlm:affiliation>Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus N, Denmark.</nlm:affiliation><country xml:lang="fr">Danemark</country><wicri:regionArea>Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus N</wicri:regionArea><wicri:noRegion>Aarhus N</wicri:noRegion></affiliation></author><author><name sortKey="B Tker, Hans Erik" sort="B Tker, Hans Erik" uniqKey="B Tker H" first="Hans Erik" last="B Tker">Hans Erik B Tker</name><affiliation wicri:level="1"><nlm:affiliation>Department of Cardiology, Aarhus University Hospital, Aarhus N, Denmark.</nlm:affiliation><country xml:lang="fr">Danemark</country><wicri:regionArea>Department of Cardiology, Aarhus University Hospital, Aarhus N</wicri:regionArea><wicri:noRegion>Aarhus N</wicri:noRegion></affiliation></author><author><name sortKey="S Rensen, Henrik Toft" sort="S Rensen, Henrik Toft" uniqKey="S Rensen H" first="Henrik Toft" last="S Rensen">Henrik Toft S Rensen</name><affiliation wicri:level="1"><nlm:affiliation>Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus N, Denmark.</nlm:affiliation><country xml:lang="fr">Danemark</country><wicri:regionArea>Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus N</wicri:regionArea><wicri:noRegion>Aarhus N</wicri:noRegion></affiliation><affiliation wicri:level="4"><nlm:affiliation>Center for Population Health Sciences, Stanford University, Stanford, California, USA.</nlm:affiliation><country xml:lang="fr">États-Unis</country><wicri:regionArea>Center for Population Health Sciences, Stanford University, Stanford, California</wicri:regionArea><placeName><region type="state">Californie</region><settlement type="city">Stanford (Californie)</settlement></placeName><orgName type="university">Université Stanford</orgName></affiliation></author></analytic><series><title level="j">Thorax</title><idno type="eISSN">1468-3296</idno><imprint><date when="2020" type="published">2020</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><p><b>OBJECTIVE</b></p><p>To examine the impact of ACE inhibitor (ACE-I)/angiotensin receptor blocker (ARB) use on rate of SARS-CoV-2 infection and adverse outcomes.</p></div><div type="abstract" xml:lang="en"><p><b>METHODS</b></p><p>This nationwide case-control and cohort study included all individuals in Denmark tested for SARS-CoV-2 RNA with PCR from 27 February 2020 to 26 July 2020. We estimated confounder-adjusted ORs for a positive test among all SARS-CoV-2 tested, and inverse probability of treatment weighted 30-day risk and risk ratios (RRs) of hospitalisation, intensive care unit (ICU) admission and mortality comparing current ACE-I/ARB use with calcium channel blocker (CCB) use and with non-use.</p></div><div type="abstract" xml:lang="en"><p><b>RESULTS</b></p><p>The study included 13 501 SARS-CoV-2 PCR-positive and 1 088 695 PCR-negative individuals. Users of ACE-I/ARB had a marginally increased rate of a positive PCR when compared with CCB users (aOR 1.17, 95% CI 1.00 to 1.37), but not when compared with non-users (aOR 1.00 95% CI 0.92 to 1.09).Among PCR-positive individuals, 1466 (11%) were ACE-I/ARB users. The weighted risk of hospitalisation was 36.5% in ACE-I/ARB users and 43.3% in CCB users (RR 0.84, 95% CI 0.70 to 1.02). The risk of ICU admission was 6.3% in ACE-I/ARB users and 5.4% in CCB users (RR 1.17, 95% CI 0.64 to 2.16), while the 30-day mortality was 12.3% in ACE-I/ARB users and 13.9% in CCB users (RR 0.89, 95% CI 0.61 to 1.30). The associations were similar when ACE-I/ARB users were compared with non-users.</p></div><div type="abstract" xml:lang="en"><p><b>CONCLUSIONS</b></p><p>ACE-I/ARB use was associated neither with a consistently increased rate nor with adverse outcomes of SARS-CoV-2 infection. Our findings support the current recommendation of continuing use of ACE-Is/ARBs during the SARS-CoV-2 pandemic.</p></div><div type="abstract" xml:lang="en"><p><b>TRIAL REGISTRATION NUMBER</b></p><p>EUPAS34887.</p></div></front></TEI><pubmed><MedlineCitation Status="Publisher" Owner="NLM"><PMID Version="1">33293279</PMID><DateRevised><Year>2021</Year><Month>01</Month><Day>10</Day></DateRevised><Article PubModel="Print-Electronic"><Journal><ISSN IssnType="Electronic">1468-3296</ISSN><JournalIssue CitedMedium="Internet"><PubDate><Year>2020</Year><Month>Dec</Month><Day>08</Day></PubDate></JournalIssue><Title>Thorax</Title><ISOAbbreviation>Thorax</ISOAbbreviation></Journal><ArticleTitle>SARS-CoV-2 infection and adverse outcomes in users of ACE inhibitors and angiotensin-receptor blockers: a nationwide case-control and cohort analysis.</ArticleTitle><ELocationID EIdType="pii" ValidYN="Y">thoraxjnl-2020-215768</ELocationID><ELocationID EIdType="doi" ValidYN="Y">10.1136/thoraxjnl-2020-215768</ELocationID><Abstract><AbstractText Label="OBJECTIVE" NlmCategory="OBJECTIVE">To examine the impact of ACE inhibitor (ACE-I)/angiotensin receptor blocker (ARB) use on rate of SARS-CoV-2 infection and adverse outcomes.</AbstractText><AbstractText Label="METHODS" NlmCategory="METHODS">This nationwide case-control and cohort study included all individuals in Denmark tested for SARS-CoV-2 RNA with PCR from 27 February 2020 to 26 July 2020. We estimated confounder-adjusted ORs for a positive test among all SARS-CoV-2 tested, and inverse probability of treatment weighted 30-day risk and risk ratios (RRs) of hospitalisation, intensive care unit (ICU) admission and mortality comparing current ACE-I/ARB use with calcium channel blocker (CCB) use and with non-use.</AbstractText><AbstractText Label="RESULTS" NlmCategory="RESULTS">The study included 13 501 SARS-CoV-2 PCR-positive and 1 088 695 PCR-negative individuals. Users of ACE-I/ARB had a marginally increased rate of a positive PCR when compared with CCB users (aOR 1.17, 95% CI 1.00 to 1.37), but not when compared with non-users (aOR 1.00 95% CI 0.92 to 1.09).Among PCR-positive individuals, 1466 (11%) were ACE-I/ARB users. The weighted risk of hospitalisation was 36.5% in ACE-I/ARB users and 43.3% in CCB users (RR 0.84, 95% CI 0.70 to 1.02). The risk of ICU admission was 6.3% in ACE-I/ARB users and 5.4% in CCB users (RR 1.17, 95% CI 0.64 to 2.16), while the 30-day mortality was 12.3% in ACE-I/ARB users and 13.9% in CCB users (RR 0.89, 95% CI 0.61 to 1.30). The associations were similar when ACE-I/ARB users were compared with non-users.</AbstractText><AbstractText Label="CONCLUSIONS" NlmCategory="CONCLUSIONS">ACE-I/ARB use was associated neither with a consistently increased rate nor with adverse outcomes of SARS-CoV-2 infection. Our findings support the current recommendation of continuing use of ACE-Is/ARBs during the SARS-CoV-2 pandemic.</AbstractText><AbstractText Label="TRIAL REGISTRATION NUMBER" NlmCategory="BACKGROUND">EUPAS34887.</AbstractText><CopyrightInformation>© Author(s) (or their employer(s)) 2020. No commercial re-use. See rights and permissions. Published by BMJ.</CopyrightInformation></Abstract><AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Christiansen</LastName><ForeName>Christian Fynbo</ForeName><Initials>CF</Initials><Identifier Source="ORCID">http://orcid.org/0000-0002-0727-953X</Identifier><AffiliationInfo><Affiliation>Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus N, Denmark cfc@clin.au.dk.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Pottegård</LastName><ForeName>Anton</ForeName><Initials>A</Initials><AffiliationInfo><Affiliation>Clinical Pharmacology, Pharmacy and Environmental Medicine, Department of Public Health, University of Southern Denmark, Odense C, Denmark.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Heide-Jørgensen</LastName><ForeName>Uffe</ForeName><Initials>U</Initials><AffiliationInfo><Affiliation>Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus N, Denmark.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Bodilsen</LastName><ForeName>Jacob</ForeName><Initials>J</Initials><Identifier Source="ORCID">http://orcid.org/0000-0002-7398-814X</Identifier><AffiliationInfo><Affiliation>Department of Infectious Diseases, Aalborg University Hospital, Aalborg, Denmark.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Søgaard</LastName><ForeName>Ole Schmeltz</ForeName><Initials>OS</Initials><AffiliationInfo><Affiliation>Department of Infectious Diseases, Aarhus University Hospital, Aarhus N, Denmark.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Maeng</LastName><ForeName>Michael</ForeName><Initials>M</Initials><AffiliationInfo><Affiliation>Department of Cardiology, Aarhus University Hospital, Aarhus N, Denmark.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Vistisen</LastName><ForeName>Simon Tilma</ForeName><Initials>ST</Initials><AffiliationInfo><Affiliation>Department of Clinical Medicine, Aarhus University, Aarhus N, Denmark.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>Department of Intensive Care, Aarhus University Hospital, Aarhus N, Denmark.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Schmidt</LastName><ForeName>Morten</ForeName><Initials>M</Initials><AffiliationInfo><Affiliation>Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus N, Denmark.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>Department of Cardiology, Aarhus University Hospital, Aarhus N, Denmark.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>Department of Cardiology, Regional Hospital West Jutland, Herning, Denmark.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Lund</LastName><ForeName>Lars Christian</ForeName><Initials>LC</Initials><AffiliationInfo><Affiliation>Clinical Pharmacology, Pharmacy and Environmental Medicine, Department of Public Health, University of Southern Denmark, Odense C, Denmark.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Reilev</LastName><ForeName>Mette</ForeName><Initials>M</Initials><Identifier Source="ORCID">http://orcid.org/0000-0003-1241-4385</Identifier><AffiliationInfo><Affiliation>Clinical Pharmacology, Pharmacy and Environmental Medicine, Department of Public Health, University of Southern Denmark, Odense C, Denmark.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Hallas</LastName><ForeName>Jesper</ForeName><Initials>J</Initials><AffiliationInfo><Affiliation>Clinical Pharmacology, Pharmacy and Environmental Medicine, Department of Public Health, University of Southern Denmark, Odense C, Denmark.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Voldstedlund</LastName><ForeName>Marianne</ForeName><Initials>M</Initials><AffiliationInfo><Affiliation>Department of Data Integration and Analysis, Statens Serum Institut, Copenhagen S, Denmark.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Husby</LastName><ForeName>Anders</ForeName><Initials>A</Initials><AffiliationInfo><Affiliation>Department of Epidemiology Research, Statens Serum Institut, Copenhagen S, Denmark.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Thomsen</LastName><ForeName>Marianne Kragh</ForeName><Initials>MK</Initials><AffiliationInfo><Affiliation>Department of Clinical Microbiology, Aarhus University Hospital, Aarhus N, Denmark.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Johansen</LastName><ForeName>Nanna Borup</ForeName><Initials>NB</Initials><AffiliationInfo><Affiliation>Department of Medical Evaluation and Biostatistics, Danish Medicines Agency, Copenhagen S, Denmark.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Brun</LastName><ForeName>Nikolai Constantin</ForeName><Initials>NC</Initials><AffiliationInfo><Affiliation>Department of Medical Evaluation and Biostatistics, Danish Medicines Agency, Copenhagen S, Denmark.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Thomsen</LastName><ForeName>Reimar Wernich</ForeName><Initials>RW</Initials><Identifier Source="ORCID">http://orcid.org/0000-0001-9135-3474</Identifier><AffiliationInfo><Affiliation>Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus N, Denmark.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Bøtker</LastName><ForeName>Hans Erik</ForeName><Initials>HE</Initials><AffiliationInfo><Affiliation>Department of Cardiology, Aarhus University Hospital, Aarhus N, Denmark.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Sørensen</LastName><ForeName>Henrik Toft</ForeName><Initials>HT</Initials><AffiliationInfo><Affiliation>Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus N, Denmark.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>Center for Population Health Sciences, Stanford University, Stanford, California, USA.</Affiliation></AffiliationInfo></Author></AuthorList><Language>eng</Language><PublicationTypeList><PublicationType UI="D016428">Journal Article</PublicationType></PublicationTypeList><ArticleDate DateType="Electronic"><Year>2020</Year><Month>12</Month><Day>08</Day></ArticleDate></Article><MedlineJournalInfo><Country>England</Country><MedlineTA>Thorax</MedlineTA><NlmUniqueID>0417353</NlmUniqueID><ISSNLinking>0040-6376</ISSNLinking></MedlineJournalInfo><CitationSubset>IM</CitationSubset><KeywordList Owner="NOTNLM"><Keyword MajorTopicYN="N">clinical epidemiology</Keyword><Keyword MajorTopicYN="N">critical care</Keyword><Keyword MajorTopicYN="N">respiratory infection</Keyword><Keyword MajorTopicYN="N">viral infection</Keyword></KeywordList><CoiStatement>Competing interests: CFC, UH-J, RWT and HTS have not received any personal fees, grants, travel grants or teaching grants from companies, but the Department of Clinical Epidemiology is involved in studies with funding from various companies as research grants to (and administered by) Aarhus University. MR, LCL, AP and JH have participated in industry-funded projects with money paid to their employer, the University of Southern Denmark. MM has received speaker or advisory board fees from AstraZeneca, Bayer, Boston Scientific, Boehringer-Ingelheim, Bristol-Myers Squibb, and Novo Nordisk.</CoiStatement></MedlineCitation><PubmedData><History><PubMedPubDate PubStatus="received"><Year>2020</Year><Month>07</Month><Day>12</Day></PubMedPubDate><PubMedPubDate PubStatus="revised"><Year>2020</Year><Month>10</Month><Day>14</Day></PubMedPubDate><PubMedPubDate PubStatus="accepted"><Year>2020</Year><Month>11</Month><Day>03</Day></PubMedPubDate><PubMedPubDate PubStatus="pubmed"><Year>2020</Year><Month>12</Month><Day>10</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="medline"><Year>2020</Year><Month>12</Month><Day>10</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="entrez"><Year>2020</Year><Month>12</Month><Day>9</Day><Hour>6</Hour><Minute>5</Minute></PubMedPubDate></History><PublicationStatus>aheadofprint</PublicationStatus><ArticleIdList><ArticleId 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name="Danemark"><noRegion><name sortKey="Christiansen, Christian Fynbo" sort="Christiansen, Christian Fynbo" uniqKey="Christiansen C" first="Christian Fynbo" last="Christiansen">Christian Fynbo Christiansen</name></noRegion><name sortKey="B Tker, Hans Erik" sort="B Tker, Hans Erik" uniqKey="B Tker H" first="Hans Erik" last="B Tker">Hans Erik B Tker</name><name sortKey="Bodilsen, Jacob" sort="Bodilsen, Jacob" uniqKey="Bodilsen J" first="Jacob" last="Bodilsen">Jacob Bodilsen</name><name sortKey="Brun, Nikolai Constantin" sort="Brun, Nikolai Constantin" uniqKey="Brun N" first="Nikolai Constantin" last="Brun">Nikolai Constantin Brun</name><name sortKey="Hallas, Jesper" sort="Hallas, Jesper" uniqKey="Hallas J" first="Jesper" last="Hallas">Jesper Hallas</name><name sortKey="Heide J Rgensen, Uffe" sort="Heide J Rgensen, Uffe" uniqKey="Heide J Rgensen U" first="Uffe" last="Heide-J Rgensen">Uffe Heide-J Rgensen</name><name sortKey="Husby, Anders" sort="Husby, Anders" uniqKey="Husby A" first="Anders" last="Husby">Anders Husby</name><name sortKey="Johansen, Nanna Borup" sort="Johansen, Nanna Borup" uniqKey="Johansen N" first="Nanna Borup" last="Johansen">Nanna Borup Johansen</name><name sortKey="Lund, Lars Christian" sort="Lund, Lars Christian" uniqKey="Lund L" first="Lars Christian" last="Lund">Lars Christian Lund</name><name sortKey="Maeng, Michael" sort="Maeng, Michael" uniqKey="Maeng M" first="Michael" last="Maeng">Michael Maeng</name><name sortKey="Potteg Rd, Anton" sort="Potteg Rd, Anton" uniqKey="Potteg Rd A" first="Anton" last="Potteg Rd">Anton Potteg Rd</name><name sortKey="Reilev, Mette" sort="Reilev, Mette" uniqKey="Reilev M" first="Mette" last="Reilev">Mette Reilev</name><name sortKey="S Gaard, Ole Schmeltz" sort="S Gaard, Ole Schmeltz" uniqKey="S Gaard O" first="Ole Schmeltz" last="S Gaard">Ole Schmeltz S Gaard</name><name sortKey="S Rensen, Henrik Toft" sort="S Rensen, Henrik Toft" uniqKey="S Rensen H" first="Henrik Toft" last="S Rensen">Henrik Toft S Rensen</name><name sortKey="Schmidt, Morten" sort="Schmidt, Morten" uniqKey="Schmidt M" first="Morten" last="Schmidt">Morten Schmidt</name><name sortKey="Schmidt, Morten" sort="Schmidt, Morten" uniqKey="Schmidt M" first="Morten" last="Schmidt">Morten Schmidt</name><name sortKey="Schmidt, Morten" sort="Schmidt, Morten" uniqKey="Schmidt M" first="Morten" last="Schmidt">Morten Schmidt</name><name sortKey="Thomsen, Marianne Kragh" sort="Thomsen, Marianne Kragh" uniqKey="Thomsen M" first="Marianne Kragh" last="Thomsen">Marianne Kragh Thomsen</name><name sortKey="Thomsen, Reimar Wernich" sort="Thomsen, Reimar Wernich" uniqKey="Thomsen R" first="Reimar Wernich" last="Thomsen">Reimar Wernich Thomsen</name><name sortKey="Vistisen, Simon Tilma" sort="Vistisen, Simon Tilma" uniqKey="Vistisen S" first="Simon Tilma" last="Vistisen">Simon Tilma Vistisen</name><name sortKey="Vistisen, Simon Tilma" sort="Vistisen, Simon Tilma" uniqKey="Vistisen S" first="Simon Tilma" last="Vistisen">Simon Tilma Vistisen</name><name sortKey="Voldstedlund, Marianne" sort="Voldstedlund, Marianne" uniqKey="Voldstedlund M" first="Marianne" last="Voldstedlund">Marianne Voldstedlund</name></country><country name="États-Unis"><region name="Californie"><name sortKey="S Rensen, Henrik Toft" sort="S Rensen, Henrik Toft" uniqKey="S Rensen H" first="Henrik Toft" last="S Rensen">Henrik Toft S Rensen</name></region></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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