CovidStanfordV1, Main, Exploration, bibRecord, 000322

Renin-Angiotensin System Blockers and Adverse Outcomes of Influenza and Pneumonia: A Danish Cohort Study.

Identifieur interne : 000322 ( Main/Exploration ); précédent : 000321; suivant : 000323

Renin-Angiotensin System Blockers and Adverse Outcomes of Influenza and Pneumonia: A Danish Cohort Study.

Auteurs : Christian Fynbo Christiansen ; Uffe Heide-J Rgensen ; Thomas B Jer Rasmussen ; Jacob Bodilsen ; Ole Schmeltz S Gaard ; Michael Maeng ; Simon Tilma Vistisen ; Morten Schmidt ; Anton Potteg Rd ; Lars Christian Lund ; Mette Reilev ; Jesper Hallas ; Nanna Borup Johansen ; Nikolai Constantin Brun ; Henrik Toft S Rensen ; Reimar Wernich Thomsen

Source :

Journal of the American Heart Association [ 2047-9980 ] ; 2020.

RBID : pubmed:32998607

Descripteurs français

KwdFr :
- Antagonistes des récepteurs aux angiotensines (usage thérapeutique), Betacoronavirus (MeSH), Danemark (épidémiologie), Femelle (MeSH), Grippe humaine (traitement médicamenteux), Grippe humaine (épidémiologie), Humains (MeSH), Incidence (MeSH), Infections à coronavirus (traitement médicamenteux), Inhibiteurs de l'enzyme de conversion de l'angiotensine (usage thérapeutique), Mâle (MeSH), Odds ratio (MeSH), Pandémies (MeSH), Pneumopathie infectieuse (traitement médicamenteux), Pneumopathie infectieuse (épidémiologie), Pneumopathie virale (traitement médicamenteux), Score de propension (MeSH), Sujet âgé (MeSH), Sujet âgé de 80 ans ou plus (MeSH), Système rénine-angiotensine (effets des médicaments et des substances chimiques), Taux de survie (tendances), Études de suivi (MeSH), Études rétrospectives (MeSH).
MESH :
- effets des médicaments et des substances chimiques : Système rénine-angiotensine.
- tendances : Taux de survie.
- traitement médicamenteux : Grippe humaine, Infections à coronavirus, Pneumopathie infectieuse, Pneumopathie virale.
- usage thérapeutique : Antagonistes des récepteurs aux angiotensines, Inhibiteurs de l'enzyme de conversion de l'angiotensine.
- épidémiologie : Danemark, Grippe humaine, Pneumopathie infectieuse.
- Betacoronavirus, Femelle, Humains, Incidence, Mâle, Odds ratio, Pandémies, Score de propension, Sujet âgé, Sujet âgé de 80 ans ou plus, Études de suivi, Études rétrospectives.
Wicri :
- geographic : Danemark.

English descriptors

KwdEn :
- Aged (MeSH), Aged, 80 and over (MeSH), Angiotensin Receptor Antagonists (therapeutic use), Angiotensin-Converting Enzyme Inhibitors (therapeutic use), Betacoronavirus (MeSH), COVID-19 (MeSH), Coronavirus Infections (drug therapy), Denmark (epidemiology), Female (MeSH), Follow-Up Studies (MeSH), Humans (MeSH), Incidence (MeSH), Influenza, Human (drug therapy), Influenza, Human (epidemiology), Male (MeSH), Odds Ratio (MeSH), Pandemics (MeSH), Pneumonia (drug therapy), Pneumonia (epidemiology), Pneumonia, Viral (drug therapy), Propensity Score (MeSH), Renin-Angiotensin System (drug effects), Retrospective Studies (MeSH), SARS-CoV-2 (MeSH), Survival Rate (trends).
MESH :
- chemical , therapeutic use : Angiotensin Receptor Antagonists, Angiotensin-Converting Enzyme Inhibitors.
- geographic , epidemiology : Denmark.
- drug effects : Renin-Angiotensin System.
- drug therapy : Coronavirus Infections, Influenza, Human, Pneumonia, Pneumonia, Viral.
- epidemiology : Influenza, Human, Pneumonia.
- trends : Survival Rate.
- Aged, Aged, 80 and over, Betacoronavirus, COVID-19, Female, Follow-Up Studies, Humans, Incidence, Male, Odds Ratio, Pandemics, Propensity Score, Retrospective Studies, SARS-CoV-2.

Abstract

Background Angiotensin-converting enzyme inhibitors (ACE-Is) and angiotensin receptor blockers (ARBs) may worsen the prognosis of coronavirus disease 2019, but any association could be confounded by the cardiometabolic conditions indicating ACE-I/ARB use. We therefore examined the impact of ACE-Is/ARBs on respiratory tract infection outcomes. Methods and Results This cohort study included all adult patients hospitalized with influenza or pneumonia from 2005 to 2018 in Denmark using population-based medical databases. Thirty-day mortality and risk of admission to the intensive care unit in ACE-Is/ARBs users was compared with nonusers and with users of calcium channel blockers. We used propensity scores to handle confounding and computed propensity score-weighted risks, risk differences (RDs), and risk ratios (RRs). Of 568 019 patients hospitalized with influenza or pneumonia, 100 278 were ACE-I/ARB users and 37 961 were users of calcium channel blockers. In propensity score-weighted analyses, ACE-I/ARB users had marginally lower 30-day mortality than users of calcium channel blockers (13.9% versus 14.5%; RD, -0.6%; 95% CI, -1.0 to -0.1; RR, 0.96; 95% CI, 0.93-0.99), and a lower risk of admission to the intensive care unit (8.0% versus 9.6%; RD, -1.6%; 95% CI, -2.0 to -1.2; RR, 0.83; 95% CI, 0.80-0.87). Compared with nonusers, current ACE-I/ARB users had lower mortality (RD, -2.4%; 95% CI, -2.8 to -2.0; RR, 0.85; 95% CI, 0.83-0.87), but similar risk of admission to the intensive care unit (RD, 0.4%; 95% CI, 0.0-0.7; RR, 1.04; 95% CI, 1.00-1.09). Conclusions Among patients with influenza or pneumonia, ACE-I/ARB users had no increased risk of admission to the intensive care unit and slightly reduced mortality after controlling for confounding.

DOI: 10.1161/JAHA.120.017297
PubMed: 32998607
PubMed Central: PMC7792378

Affiliations:

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Le document en format XML

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<author><name sortKey="Christiansen, Christian Fynbo" sort="Christiansen, Christian Fynbo" uniqKey="Christiansen C" first="Christian Fynbo" last="Christiansen">Christian Fynbo Christiansen</name>
<affiliation><nlm:affiliation>Department of Clinical Epidemiology Aarhus University Hospital Aarhus Denmark.</nlm:affiliation>
<wicri:noCountry code="no comma">Department of Clinical Epidemiology Aarhus University Hospital Aarhus Denmark.</wicri:noCountry>
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<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>
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<wicri:noCountry code="no comma">Department of Clinical Epidemiology Aarhus University Hospital Aarhus Denmark.</wicri:noCountry>
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<wicri:noCountry code="no comma">Department of Clinical Epidemiology Aarhus University Hospital Aarhus Denmark.</wicri:noCountry>
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<wicri:noCountry code="no comma">Department of Infectious Diseases Aalborg University Hospital Aalborg Denmark.</wicri:noCountry>
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</affiliation>
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<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>
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<author><name sortKey="Maeng, Michael" sort="Maeng, Michael" uniqKey="Maeng M" first="Michael" last="Maeng">Michael Maeng</name>
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<author><name sortKey="Vistisen, Simon Tilma" sort="Vistisen, Simon Tilma" uniqKey="Vistisen S" first="Simon Tilma" last="Vistisen">Simon Tilma Vistisen</name>
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</affiliation>
<affiliation><nlm:affiliation>Department of Clinical Medicine Aarhus University Aarhus Denmark.</nlm:affiliation>
<wicri:noCountry code="no comma">Department of Clinical Medicine Aarhus University Aarhus Denmark.</wicri:noCountry>
<wicri:noCountry code="no comma">Department of Clinical Medicine Aarhus University Aarhus Denmark.</wicri:noCountry>
</affiliation>
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<author><name sortKey="Schmidt, Morten" sort="Schmidt, Morten" uniqKey="Schmidt M" first="Morten" last="Schmidt">Morten Schmidt</name>
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<wicri:noCountry code="no comma">Department of Clinical Epidemiology Aarhus University Hospital Aarhus Denmark.</wicri:noCountry>
<wicri:noCountry code="no comma">Department of Clinical Epidemiology Aarhus University Hospital Aarhus Denmark.</wicri:noCountry>
</affiliation>
<affiliation><nlm:affiliation>Department of Cardiology Aarhus University Hospital Aarhus Denmark.</nlm:affiliation>
<wicri:noCountry code="no comma">Department of Cardiology Aarhus University Hospital Aarhus Denmark.</wicri:noCountry>
<wicri:noCountry code="no comma">Department of Cardiology Aarhus University Hospital Aarhus Denmark.</wicri:noCountry>
</affiliation>
<affiliation><nlm:affiliation>Department of Cardiology Regional Hospital West Jutland Herning Denmark.</nlm:affiliation>
<wicri:noCountry code="no comma">Department of Cardiology Regional Hospital West Jutland Herning Denmark.</wicri:noCountry>
<wicri:noCountry code="no comma">Department of Cardiology Regional Hospital West Jutland Herning Denmark.</wicri:noCountry>
</affiliation>
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<author><name sortKey="Potteg Rd, Anton" sort="Potteg Rd, Anton" uniqKey="Potteg Rd A" first="Anton" last="Potteg Rd">Anton Potteg Rd</name>
<affiliation><nlm:affiliation>Clinical Pharmacology and Pharmacy Department of Public Health University of Southern Denmark Odense Denmark.</nlm:affiliation>
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<author><name sortKey="Lund, Lars Christian" sort="Lund, Lars Christian" uniqKey="Lund L" first="Lars Christian" last="Lund">Lars Christian Lund</name>
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<author><name sortKey="Reilev, Mette" sort="Reilev, Mette" uniqKey="Reilev M" first="Mette" last="Reilev">Mette Reilev</name>
<affiliation><nlm:affiliation>Clinical Pharmacology and Pharmacy Department of Public Health University of Southern Denmark Odense Denmark.</nlm:affiliation>
<wicri:noCountry code="no comma">Clinical Pharmacology and Pharmacy Department of Public Health University of Southern Denmark Odense Denmark.</wicri:noCountry>
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<author><name sortKey="Hallas, Jesper" sort="Hallas, Jesper" uniqKey="Hallas J" first="Jesper" last="Hallas">Jesper Hallas</name>
<affiliation><nlm:affiliation>Clinical Pharmacology and Pharmacy Department of Public Health University of Southern Denmark Odense Denmark.</nlm:affiliation>
<wicri:noCountry code="no comma">Clinical Pharmacology and Pharmacy Department of Public Health University of Southern Denmark Odense Denmark.</wicri:noCountry>
<wicri:noCountry code="no comma">Clinical Pharmacology and Pharmacy Department of Public Health University of Southern Denmark Odense Denmark.</wicri:noCountry>
</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><nlm:affiliation>Department of Medical Evaluation and Biostatistics Danish Medicines Agency Copenhagen Denmark.</nlm:affiliation>
<wicri:noCountry code="no comma">Department of Medical Evaluation and Biostatistics Danish Medicines Agency Copenhagen Denmark.</wicri:noCountry>
<wicri:noCountry code="no comma">Department of Medical Evaluation and Biostatistics Danish Medicines Agency Copenhagen Denmark.</wicri:noCountry>
</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><nlm:affiliation>Department of Medical Evaluation and Biostatistics Danish Medicines Agency Copenhagen Denmark.</nlm:affiliation>
<wicri:noCountry code="no comma">Department of Medical Evaluation and Biostatistics Danish Medicines Agency Copenhagen Denmark.</wicri:noCountry>
<wicri:noCountry code="no comma">Department of Medical Evaluation and Biostatistics Danish Medicines Agency Copenhagen Denmark.</wicri:noCountry>
</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><nlm:affiliation>Department of Clinical Epidemiology Aarhus University Hospital Aarhus Denmark.</nlm:affiliation>
<wicri:noCountry code="no comma">Department of Clinical Epidemiology Aarhus University Hospital Aarhus Denmark.</wicri:noCountry>
<wicri:noCountry code="no comma">Department of Clinical Epidemiology Aarhus University Hospital Aarhus Denmark.</wicri:noCountry>
</affiliation>
<affiliation><nlm:affiliation>Center for Population Health Sciences Stanford University Stanford CA.</nlm:affiliation>
<wicri:noCountry code="no comma">Center for Population Health Sciences Stanford University Stanford CA.</wicri:noCountry>
<wicri:noCountry code="no comma">Center for Population Health Sciences Stanford University Stanford CA.</wicri:noCountry>
</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><nlm:affiliation>Department of Clinical Epidemiology Aarhus University Hospital Aarhus Denmark.</nlm:affiliation>
<wicri:noCountry code="no comma">Department of Clinical Epidemiology Aarhus University Hospital Aarhus Denmark.</wicri:noCountry>
<wicri:noCountry code="no comma">Department of Clinical Epidemiology Aarhus University Hospital Aarhus Denmark.</wicri:noCountry>
</affiliation>
</author>
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<sourceDesc><biblStruct><analytic><title xml:lang="en">Renin-Angiotensin System Blockers and Adverse Outcomes of Influenza and Pneumonia: A Danish Cohort Study.</title>
<author><name sortKey="Christiansen, Christian Fynbo" sort="Christiansen, Christian Fynbo" uniqKey="Christiansen C" first="Christian Fynbo" last="Christiansen">Christian Fynbo Christiansen</name>
<affiliation><nlm:affiliation>Department of Clinical Epidemiology Aarhus University Hospital Aarhus Denmark.</nlm:affiliation>
<wicri:noCountry code="no comma">Department of Clinical Epidemiology Aarhus University Hospital Aarhus Denmark.</wicri:noCountry>
<wicri:noCountry code="no comma">Department of Clinical Epidemiology Aarhus University Hospital Aarhus Denmark.</wicri:noCountry>
</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><nlm:affiliation>Department of Clinical Epidemiology Aarhus University Hospital Aarhus Denmark.</nlm:affiliation>
<wicri:noCountry code="no comma">Department of Clinical Epidemiology Aarhus University Hospital Aarhus Denmark.</wicri:noCountry>
<wicri:noCountry code="no comma">Department of Clinical Epidemiology Aarhus University Hospital Aarhus Denmark.</wicri:noCountry>
</affiliation>
</author>
<author><name sortKey="Rasmussen, Thomas B Jer" sort="Rasmussen, Thomas B Jer" uniqKey="Rasmussen T" first="Thomas B Jer" last="Rasmussen">Thomas B Jer Rasmussen</name>
<affiliation><nlm:affiliation>Department of Clinical Epidemiology Aarhus University Hospital Aarhus Denmark.</nlm:affiliation>
<wicri:noCountry code="no comma">Department of Clinical Epidemiology Aarhus University Hospital Aarhus Denmark.</wicri:noCountry>
<wicri:noCountry code="no comma">Department of Clinical Epidemiology Aarhus University Hospital Aarhus Denmark.</wicri:noCountry>
</affiliation>
</author>
<author><name sortKey="Bodilsen, Jacob" sort="Bodilsen, Jacob" uniqKey="Bodilsen J" first="Jacob" last="Bodilsen">Jacob Bodilsen</name>
<affiliation><nlm:affiliation>Department of Infectious Diseases Aalborg University Hospital Aalborg Denmark.</nlm:affiliation>
<wicri:noCountry code="no comma">Department of Infectious Diseases Aalborg University Hospital Aalborg Denmark.</wicri:noCountry>
<wicri:noCountry code="no comma">Department of Infectious Diseases Aalborg University Hospital Aalborg Denmark.</wicri:noCountry>
</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><nlm:affiliation>Department of Infectious Diseases Aarhus University Hospital Aarhus Denmark.</nlm:affiliation>
<wicri:noCountry code="no comma">Department of Infectious Diseases Aarhus University Hospital Aarhus Denmark.</wicri:noCountry>
<wicri:noCountry code="no comma">Department of Infectious Diseases Aarhus University Hospital Aarhus Denmark.</wicri:noCountry>
</affiliation>
</author>
<author><name sortKey="Maeng, Michael" sort="Maeng, Michael" uniqKey="Maeng M" first="Michael" last="Maeng">Michael Maeng</name>
<affiliation><nlm:affiliation>Department of Cardiology Aarhus University Hospital Aarhus Denmark.</nlm:affiliation>
<wicri:noCountry code="no comma">Department of Cardiology Aarhus University Hospital Aarhus Denmark.</wicri:noCountry>
<wicri:noCountry code="no comma">Department of Cardiology Aarhus University Hospital Aarhus Denmark.</wicri:noCountry>
</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><nlm:affiliation>Department of Intensive Care Aarhus University Hospital Aarhus Denmark.</nlm:affiliation>
<wicri:noCountry code="no comma">Department of Intensive Care Aarhus University Hospital Aarhus Denmark.</wicri:noCountry>
<wicri:noCountry code="no comma">Department of Intensive Care Aarhus University Hospital Aarhus Denmark.</wicri:noCountry>
</affiliation>
<affiliation><nlm:affiliation>Department of Clinical Medicine Aarhus University Aarhus Denmark.</nlm:affiliation>
<wicri:noCountry code="no comma">Department of Clinical Medicine Aarhus University Aarhus Denmark.</wicri:noCountry>
<wicri:noCountry code="no comma">Department of Clinical Medicine Aarhus University Aarhus Denmark.</wicri:noCountry>
</affiliation>
</author>
<author><name sortKey="Schmidt, Morten" sort="Schmidt, Morten" uniqKey="Schmidt M" first="Morten" last="Schmidt">Morten Schmidt</name>
<affiliation><nlm:affiliation>Department of Clinical Epidemiology Aarhus University Hospital Aarhus Denmark.</nlm:affiliation>
<wicri:noCountry code="no comma">Department of Clinical Epidemiology Aarhus University Hospital Aarhus Denmark.</wicri:noCountry>
<wicri:noCountry code="no comma">Department of Clinical Epidemiology Aarhus University Hospital Aarhus Denmark.</wicri:noCountry>
</affiliation>
<affiliation><nlm:affiliation>Department of Cardiology Aarhus University Hospital Aarhus Denmark.</nlm:affiliation>
<wicri:noCountry code="no comma">Department of Cardiology Aarhus University Hospital Aarhus Denmark.</wicri:noCountry>
<wicri:noCountry code="no comma">Department of Cardiology Aarhus University Hospital Aarhus Denmark.</wicri:noCountry>
</affiliation>
<affiliation><nlm:affiliation>Department of Cardiology Regional Hospital West Jutland Herning Denmark.</nlm:affiliation>
<wicri:noCountry code="no comma">Department of Cardiology Regional Hospital West Jutland Herning Denmark.</wicri:noCountry>
<wicri:noCountry code="no comma">Department of Cardiology Regional Hospital West Jutland Herning Denmark.</wicri:noCountry>
</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><nlm:affiliation>Clinical Pharmacology and Pharmacy Department of Public Health University of Southern Denmark Odense Denmark.</nlm:affiliation>
<wicri:noCountry code="no comma">Clinical Pharmacology and Pharmacy Department of Public Health University of Southern Denmark Odense Denmark.</wicri:noCountry>
<wicri:noCountry code="no comma">Clinical Pharmacology and Pharmacy Department of Public Health University of Southern Denmark Odense Denmark.</wicri:noCountry>
</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><nlm:affiliation>Clinical Pharmacology and Pharmacy Department of Public Health University of Southern Denmark Odense Denmark.</nlm:affiliation>
<wicri:noCountry code="no comma">Clinical Pharmacology and Pharmacy Department of Public Health University of Southern Denmark Odense Denmark.</wicri:noCountry>
<wicri:noCountry code="no comma">Clinical Pharmacology and Pharmacy Department of Public Health University of Southern Denmark Odense Denmark.</wicri:noCountry>
</affiliation>
</author>
<author><name sortKey="Reilev, Mette" sort="Reilev, Mette" uniqKey="Reilev M" first="Mette" last="Reilev">Mette Reilev</name>
<affiliation><nlm:affiliation>Clinical Pharmacology and Pharmacy Department of Public Health University of Southern Denmark Odense Denmark.</nlm:affiliation>
<wicri:noCountry code="no comma">Clinical Pharmacology and Pharmacy Department of Public Health University of Southern Denmark Odense Denmark.</wicri:noCountry>
<wicri:noCountry code="no comma">Clinical Pharmacology and Pharmacy Department of Public Health University of Southern Denmark Odense Denmark.</wicri:noCountry>
</affiliation>
</author>
<author><name sortKey="Hallas, Jesper" sort="Hallas, Jesper" uniqKey="Hallas J" first="Jesper" last="Hallas">Jesper Hallas</name>
<affiliation><nlm:affiliation>Clinical Pharmacology and Pharmacy Department of Public Health University of Southern Denmark Odense Denmark.</nlm:affiliation>
<wicri:noCountry code="no comma">Clinical Pharmacology and Pharmacy Department of Public Health University of Southern Denmark Odense Denmark.</wicri:noCountry>
<wicri:noCountry code="no comma">Clinical Pharmacology and Pharmacy Department of Public Health University of Southern Denmark Odense Denmark.</wicri:noCountry>
</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><nlm:affiliation>Department of Medical Evaluation and Biostatistics Danish Medicines Agency Copenhagen Denmark.</nlm:affiliation>
<wicri:noCountry code="no comma">Department of Medical Evaluation and Biostatistics Danish Medicines Agency Copenhagen Denmark.</wicri:noCountry>
<wicri:noCountry code="no comma">Department of Medical Evaluation and Biostatistics Danish Medicines Agency Copenhagen Denmark.</wicri:noCountry>
</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><nlm:affiliation>Department of Medical Evaluation and Biostatistics Danish Medicines Agency Copenhagen Denmark.</nlm:affiliation>
<wicri:noCountry code="no comma">Department of Medical Evaluation and Biostatistics Danish Medicines Agency Copenhagen Denmark.</wicri:noCountry>
<wicri:noCountry code="no comma">Department of Medical Evaluation and Biostatistics Danish Medicines Agency Copenhagen Denmark.</wicri:noCountry>
</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><nlm:affiliation>Department of Clinical Epidemiology Aarhus University Hospital Aarhus Denmark.</nlm:affiliation>
<wicri:noCountry code="no comma">Department of Clinical Epidemiology Aarhus University Hospital Aarhus Denmark.</wicri:noCountry>
<wicri:noCountry code="no comma">Department of Clinical Epidemiology Aarhus University Hospital Aarhus Denmark.</wicri:noCountry>
</affiliation>
<affiliation><nlm:affiliation>Center for Population Health Sciences Stanford University Stanford CA.</nlm:affiliation>
<wicri:noCountry code="no comma">Center for Population Health Sciences Stanford University Stanford CA.</wicri:noCountry>
<wicri:noCountry code="no comma">Center for Population Health Sciences Stanford University Stanford CA.</wicri:noCountry>
</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><nlm:affiliation>Department of Clinical Epidemiology Aarhus University Hospital Aarhus Denmark.</nlm:affiliation>
<wicri:noCountry code="no comma">Department of Clinical Epidemiology Aarhus University Hospital Aarhus Denmark.</wicri:noCountry>
<wicri:noCountry code="no comma">Department of Clinical Epidemiology Aarhus University Hospital Aarhus Denmark.</wicri:noCountry>
</affiliation>
</author>
</analytic>
<series><title level="j">Journal of the American Heart Association</title>
<idno type="eISSN">2047-9980</idno>
<imprint><date when="2020" type="published">2020</date>
</imprint>
</series>
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<profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Aged (MeSH)</term>
<term>Aged, 80 and over (MeSH)</term>
<term>Angiotensin Receptor Antagonists (therapeutic use)</term>
<term>Angiotensin-Converting Enzyme Inhibitors (therapeutic use)</term>
<term>Betacoronavirus (MeSH)</term>
<term>COVID-19 (MeSH)</term>
<term>Coronavirus Infections (drug therapy)</term>
<term>Denmark (epidemiology)</term>
<term>Female (MeSH)</term>
<term>Follow-Up Studies (MeSH)</term>
<term>Humans (MeSH)</term>
<term>Incidence (MeSH)</term>
<term>Influenza, Human (drug therapy)</term>
<term>Influenza, Human (epidemiology)</term>
<term>Male (MeSH)</term>
<term>Odds Ratio (MeSH)</term>
<term>Pandemics (MeSH)</term>
<term>Pneumonia (drug therapy)</term>
<term>Pneumonia (epidemiology)</term>
<term>Pneumonia, Viral (drug therapy)</term>
<term>Propensity Score (MeSH)</term>
<term>Renin-Angiotensin System (drug effects)</term>
<term>Retrospective Studies (MeSH)</term>
<term>SARS-CoV-2 (MeSH)</term>
<term>Survival Rate (trends)</term>
</keywords>
<keywords scheme="KwdFr" xml:lang="fr"><term>Antagonistes des récepteurs aux angiotensines (usage thérapeutique)</term>
<term>Betacoronavirus (MeSH)</term>
<term>Danemark (épidémiologie)</term>
<term>Femelle (MeSH)</term>
<term>Grippe humaine (traitement médicamenteux)</term>
<term>Grippe humaine (épidémiologie)</term>
<term>Humains (MeSH)</term>
<term>Incidence (MeSH)</term>
<term>Infections à coronavirus (traitement médicamenteux)</term>
<term>Inhibiteurs de l'enzyme de conversion de l'angiotensine (usage thérapeutique)</term>
<term>Mâle (MeSH)</term>
<term>Odds ratio (MeSH)</term>
<term>Pandémies (MeSH)</term>
<term>Pneumopathie infectieuse (traitement médicamenteux)</term>
<term>Pneumopathie infectieuse (épidémiologie)</term>
<term>Pneumopathie virale (traitement médicamenteux)</term>
<term>Score de propension (MeSH)</term>
<term>Sujet âgé (MeSH)</term>
<term>Sujet âgé de 80 ans ou plus (MeSH)</term>
<term>Système rénine-angiotensine (effets des médicaments et des substances chimiques)</term>
<term>Taux de survie (tendances)</term>
<term>Études de suivi (MeSH)</term>
<term>Études rétrospectives (MeSH)</term>
</keywords>
<keywords scheme="MESH" type="chemical" qualifier="therapeutic use" xml:lang="en"><term>Angiotensin Receptor Antagonists</term>
<term>Angiotensin-Converting Enzyme Inhibitors</term>
</keywords>
<keywords scheme="MESH" type="geographic" qualifier="epidemiology" xml:lang="en"><term>Denmark</term>
</keywords>
<keywords scheme="MESH" qualifier="drug effects" xml:lang="en"><term>Renin-Angiotensin System</term>
</keywords>
<keywords scheme="MESH" qualifier="drug therapy" xml:lang="en"><term>Coronavirus Infections</term>
<term>Influenza, Human</term>
<term>Pneumonia</term>
<term>Pneumonia, Viral</term>
</keywords>
<keywords scheme="MESH" qualifier="effets des médicaments et des substances chimiques" xml:lang="fr"><term>Système rénine-angiotensine</term>
</keywords>
<keywords scheme="MESH" qualifier="epidemiology" xml:lang="en"><term>Influenza, Human</term>
<term>Pneumonia</term>
</keywords>
<keywords scheme="MESH" qualifier="tendances" xml:lang="fr"><term>Taux de survie</term>
</keywords>
<keywords scheme="MESH" qualifier="traitement médicamenteux" xml:lang="fr"><term>Grippe humaine</term>
<term>Infections à coronavirus</term>
<term>Pneumopathie infectieuse</term>
<term>Pneumopathie virale</term>
</keywords>
<keywords scheme="MESH" qualifier="trends" xml:lang="en"><term>Survival Rate</term>
</keywords>
<keywords scheme="MESH" qualifier="usage thérapeutique" xml:lang="fr"><term>Antagonistes des récepteurs aux angiotensines</term>
<term>Inhibiteurs de l'enzyme de conversion de l'angiotensine</term>
</keywords>
<keywords scheme="MESH" qualifier="épidémiologie" xml:lang="fr"><term>Danemark</term>
<term>Grippe humaine</term>
<term>Pneumopathie infectieuse</term>
</keywords>
<keywords scheme="MESH" xml:lang="en"><term>Aged</term>
<term>Aged, 80 and over</term>
<term>Betacoronavirus</term>
<term>COVID-19</term>
<term>Female</term>
<term>Follow-Up Studies</term>
<term>Humans</term>
<term>Incidence</term>
<term>Male</term>
<term>Odds Ratio</term>
<term>Pandemics</term>
<term>Propensity Score</term>
<term>Retrospective Studies</term>
<term>SARS-CoV-2</term>
</keywords>
<keywords scheme="MESH" xml:lang="fr"><term>Betacoronavirus</term>
<term>Femelle</term>
<term>Humains</term>
<term>Incidence</term>
<term>Mâle</term>
<term>Odds ratio</term>
<term>Pandémies</term>
<term>Score de propension</term>
<term>Sujet âgé</term>
<term>Sujet âgé de 80 ans ou plus</term>
<term>Études de suivi</term>
<term>Études rétrospectives</term>
</keywords>
<keywords scheme="Wicri" type="geographic" xml:lang="fr"><term>Danemark</term>
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<front><div type="abstract" xml:lang="en">Background Angiotensin-converting enzyme inhibitors (ACE-Is) and angiotensin receptor blockers (ARBs) may worsen the prognosis of coronavirus disease 2019, but any association could be confounded by the cardiometabolic conditions indicating ACE-I/ARB use. We therefore examined the impact of ACE-Is/ARBs on respiratory tract infection outcomes. Methods and Results This cohort study included all adult patients hospitalized with influenza or pneumonia from 2005 to 2018 in Denmark using population-based medical databases. Thirty-day mortality and risk of admission to the intensive care unit in ACE-Is/ARBs users was compared with nonusers and with users of calcium channel blockers. We used propensity scores to handle confounding and computed propensity score-weighted risks, risk differences (RDs), and risk ratios (RRs). Of 568 019 patients hospitalized with influenza or pneumonia, 100 278 were ACE-I/ARB users and 37 961 were users of calcium channel blockers. In propensity score-weighted analyses, ACE-I/ARB users had marginally lower 30-day mortality than users of calcium channel blockers (13.9% versus 14.5%; RD, -0.6%; 95% CI, -1.0 to -0.1; RR, 0.96; 95% CI, 0.93-0.99), and a lower risk of admission to the intensive care unit (8.0% versus 9.6%; RD, -1.6%; 95% CI, -2.0 to -1.2; RR, 0.83; 95% CI, 0.80-0.87). Compared with nonusers, current ACE-I/ARB users had lower mortality (RD, -2.4%; 95% CI, -2.8 to -2.0; RR, 0.85; 95% CI, 0.83-0.87), but similar risk of admission to the intensive care unit (RD, 0.4%; 95% CI, 0.0-0.7; RR, 1.04; 95% CI, 1.00-1.09). Conclusions Among patients with influenza or pneumonia, ACE-I/ARB users had no increased risk of admission to the intensive care unit and slightly reduced mortality after controlling for confounding.</div>
</front>
</TEI>
<pubmed><MedlineCitation Status="MEDLINE" Owner="NLM"><PMID Version="1">32998607</PMID>
<DateCompleted><Year>2020</Year>
<Month>10</Month>
<Day>15</Day>
</DateCompleted>
<DateRevised><Year>2021</Year>
<Month>01</Month>
<Day>16</Day>
</DateRevised>
<Article PubModel="Print-Electronic"><Journal><ISSN IssnType="Electronic">2047-9980</ISSN>
<JournalIssue CitedMedium="Internet"><Volume>9</Volume>
<Issue>19</Issue>
<PubDate><Year>2020</Year>
<Month>10</Month>
<Day>20</Day>
</PubDate>
</JournalIssue>
<Title>Journal of the American Heart Association</Title>
<ISOAbbreviation>J Am Heart Assoc</ISOAbbreviation>
</Journal>
<ArticleTitle>Renin-Angiotensin System Blockers and Adverse Outcomes of Influenza and Pneumonia: A Danish Cohort Study.</ArticleTitle>
<Pagination><MedlinePgn>e017297</MedlinePgn>
</Pagination>
<ELocationID EIdType="doi" ValidYN="Y">10.1161/JAHA.120.017297</ELocationID>
<Abstract><AbstractText>Background Angiotensin-converting enzyme inhibitors (ACE-Is) and angiotensin receptor blockers (ARBs) may worsen the prognosis of coronavirus disease 2019, but any association could be confounded by the cardiometabolic conditions indicating ACE-I/ARB use. We therefore examined the impact of ACE-Is/ARBs on respiratory tract infection outcomes. Methods and Results This cohort study included all adult patients hospitalized with influenza or pneumonia from 2005 to 2018 in Denmark using population-based medical databases. Thirty-day mortality and risk of admission to the intensive care unit in ACE-Is/ARBs users was compared with nonusers and with users of calcium channel blockers. We used propensity scores to handle confounding and computed propensity score-weighted risks, risk differences (RDs), and risk ratios (RRs). Of 568 019 patients hospitalized with influenza or pneumonia, 100 278 were ACE-I/ARB users and 37 961 were users of calcium channel blockers. In propensity score-weighted analyses, ACE-I/ARB users had marginally lower 30-day mortality than users of calcium channel blockers (13.9% versus 14.5%; RD, -0.6%; 95% CI, -1.0 to -0.1; RR, 0.96; 95% CI, 0.93-0.99), and a lower risk of admission to the intensive care unit (8.0% versus 9.6%; RD, -1.6%; 95% CI, -2.0 to -1.2; RR, 0.83; 95% CI, 0.80-0.87). Compared with nonusers, current ACE-I/ARB users had lower mortality (RD, -2.4%; 95% CI, -2.8 to -2.0; RR, 0.85; 95% CI, 0.83-0.87), but similar risk of admission to the intensive care unit (RD, 0.4%; 95% CI, 0.0-0.7; RR, 1.04; 95% CI, 1.00-1.09). Conclusions Among patients with influenza or pneumonia, ACE-I/ARB users had no increased risk of admission to the intensive care unit and slightly reduced mortality after controlling for confounding.</AbstractText>
</Abstract>
<AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Christiansen</LastName>
<ForeName>Christian Fynbo</ForeName>
<Initials>CF</Initials>
<AffiliationInfo><Affiliation>Department of Clinical Epidemiology Aarhus University Hospital Aarhus 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 Denmark.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Rasmussen</LastName>
<ForeName>Thomas Bøjer</ForeName>
<Initials>TB</Initials>
<AffiliationInfo><Affiliation>Department of Clinical Epidemiology Aarhus University Hospital Aarhus Denmark.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Bodilsen</LastName>
<ForeName>Jacob</ForeName>
<Initials>J</Initials>
<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 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 Denmark.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Vistisen</LastName>
<ForeName>Simon Tilma</ForeName>
<Initials>ST</Initials>
<AffiliationInfo><Affiliation>Department of Intensive Care Aarhus University Hospital Aarhus Denmark.</Affiliation>
</AffiliationInfo>
<AffiliationInfo><Affiliation>Department of Clinical Medicine Aarhus University Aarhus 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 Denmark.</Affiliation>
</AffiliationInfo>
<AffiliationInfo><Affiliation>Department of Cardiology Aarhus University Hospital Aarhus Denmark.</Affiliation>
</AffiliationInfo>
<AffiliationInfo><Affiliation>Department of Cardiology Regional Hospital West Jutland Herning Denmark.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Pottegård</LastName>
<ForeName>Anton</ForeName>
<Initials>A</Initials>
<AffiliationInfo><Affiliation>Clinical Pharmacology and Pharmacy Department of Public Health University of Southern Denmark Odense Denmark.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Lund</LastName>
<ForeName>Lars Christian</ForeName>
<Initials>LC</Initials>
<AffiliationInfo><Affiliation>Clinical Pharmacology and Pharmacy Department of Public Health University of Southern Denmark Odense Denmark.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Reilev</LastName>
<ForeName>Mette</ForeName>
<Initials>M</Initials>
<AffiliationInfo><Affiliation>Clinical Pharmacology and Pharmacy Department of Public Health University of Southern Denmark Odense Denmark.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Hallas</LastName>
<ForeName>Jesper</ForeName>
<Initials>J</Initials>
<AffiliationInfo><Affiliation>Clinical Pharmacology and Pharmacy Department of Public Health University of Southern Denmark Odense 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 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 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 Denmark.</Affiliation>
</AffiliationInfo>
<AffiliationInfo><Affiliation>Center for Population Health Sciences Stanford University Stanford CA.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Thomsen</LastName>
<ForeName>Reimar Wernich</ForeName>
<Initials>RW</Initials>
<AffiliationInfo><Affiliation>Department of Clinical Epidemiology Aarhus University Hospital Aarhus Denmark.</Affiliation>
</AffiliationInfo>
</Author>
</AuthorList>
<Language>eng</Language>
<PublicationTypeList><PublicationType UI="D016428">Journal Article</PublicationType>
<PublicationType UI="D016448">Multicenter Study</PublicationType>
<PublicationType UI="D013485">Research Support, Non-U.S. Gov't</PublicationType>
</PublicationTypeList>
<ArticleDate DateType="Electronic"><Year>2020</Year>
<Month>10</Month>
<Day>01</Day>
</ArticleDate>
</Article>
<MedlineJournalInfo><Country>England</Country>
<MedlineTA>J Am Heart Assoc</MedlineTA>
<NlmUniqueID>101580524</NlmUniqueID>
<ISSNLinking>2047-9980</ISSNLinking>
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<CitationSubset>IM</CitationSubset>
<MeshHeadingList><MeshHeading><DescriptorName UI="D000368" MajorTopicYN="N">Aged</DescriptorName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D000369" MajorTopicYN="N">Aged, 80 and over</DescriptorName>
</MeshHeading>
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<QualifierName UI="Q000627" MajorTopicYN="Y">therapeutic use</QualifierName>
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<QualifierName UI="Q000627" MajorTopicYN="Y">therapeutic use</QualifierName>
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<MeshHeading><DescriptorName UI="D000073640" MajorTopicYN="Y">Betacoronavirus</DescriptorName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D000086382" MajorTopicYN="N">COVID-19</DescriptorName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D018352" MajorTopicYN="N">Coronavirus Infections</DescriptorName>
<QualifierName UI="Q000188" MajorTopicYN="Y">drug therapy</QualifierName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D003718" MajorTopicYN="N" Type="Geographic">Denmark</DescriptorName>
<QualifierName UI="Q000453" MajorTopicYN="N">epidemiology</QualifierName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D005260" MajorTopicYN="N">Female</DescriptorName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D005500" MajorTopicYN="N">Follow-Up Studies</DescriptorName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D006801" MajorTopicYN="N">Humans</DescriptorName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D015994" MajorTopicYN="N">Incidence</DescriptorName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D007251" MajorTopicYN="N">Influenza, Human</DescriptorName>
<QualifierName UI="Q000188" MajorTopicYN="Y">drug therapy</QualifierName>
<QualifierName UI="Q000453" MajorTopicYN="N">epidemiology</QualifierName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D008297" MajorTopicYN="N">Male</DescriptorName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D016017" MajorTopicYN="N">Odds Ratio</DescriptorName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D058873" MajorTopicYN="N">Pandemics</DescriptorName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D011014" MajorTopicYN="N">Pneumonia</DescriptorName>
<QualifierName UI="Q000188" MajorTopicYN="Y">drug therapy</QualifierName>
<QualifierName UI="Q000453" MajorTopicYN="N">epidemiology</QualifierName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D011024" MajorTopicYN="N">Pneumonia, Viral</DescriptorName>
<QualifierName UI="Q000188" MajorTopicYN="Y">drug therapy</QualifierName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D057216" MajorTopicYN="N">Propensity Score</DescriptorName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D012084" MajorTopicYN="N">Renin-Angiotensin System</DescriptorName>
<QualifierName UI="Q000187" MajorTopicYN="Y">drug effects</QualifierName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D012189" MajorTopicYN="N">Retrospective Studies</DescriptorName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D000086402" MajorTopicYN="N">SARS-CoV-2</DescriptorName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D015996" MajorTopicYN="N">Survival Rate</DescriptorName>
<QualifierName UI="Q000639" MajorTopicYN="N">trends</QualifierName>
</MeshHeading>
</MeshHeadingList>
<KeywordList Owner="NOTNLM"><Keyword MajorTopicYN="Y">angiotensin receptor blockers</Keyword>
<Keyword MajorTopicYN="Y">angiotensin‐converting enzyme inhibitor</Keyword>
<Keyword MajorTopicYN="Y">cohort study</Keyword>
<Keyword MajorTopicYN="Y">infectious disease</Keyword>
<Keyword MajorTopicYN="Y">intensive care unit</Keyword>
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Renin-Angiotensin System Blockers and Adverse Outcomes of Influenza and Pneumonia: A Danish Cohort Study.

Renin-Angiotensin System Blockers and Adverse Outcomes of Influenza and Pneumonia: A Danish Cohort Study.

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