Discontinuing vs continuing ACEIs and ARBs in hospitalized patients with COVID-19 according to disease severity: Insights from the BRACE CORONA trial

Bibliographic Details
Main Author: Macedo, Ariane Vieira Scarlatelli
Publication Date: 2022
Other Authors: Barros E Silva, Pedro Gabriel Melo de, Paula, Thiago Ceccatto de, Moll-Bernardes, Renata Junqueira, Santos, Tiago Mendonça dos, Mazza, Lilian, Feldman, Andre, Arruda, Guilherme D. Andréa Saba, Albuquerque, Denílson Campos de, Sousa, Andrea Silvestre de, Souza, Olga Ferreira de, Gibson, C. Michael, Granger, Christopher B., Alexander, John H., Lopes, Renato D.
Format: Article
Language: eng
Source: Repositório Institucional da FIOCRUZ (ARCA)
Download full: https://www.arca.fiocruz.br/handle/icict/53393
Summary: D'Or Institute for Research and Education. Rio de Janeiro, RJ, Brazil / Hospital São Luiz Jabaquara. São Paulo, SP, Brazil / Universidade Federal de São Paulo. Programa de Pós-Graduação em Medicina Translacional. São Paulo, SP, Brazil / Brazilian Clinical Research Institute. São Paulo, SP, Brazil.
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spelling Macedo, Ariane Vieira ScarlatelliBarros E Silva, Pedro Gabriel Melo dePaula, Thiago Ceccatto deMoll-Bernardes, Renata JunqueiraSantos, Tiago Mendonça dosMazza, LilianFeldman, AndreArruda, Guilherme D. Andréa SabaAlbuquerque, Denílson Campos deSousa, Andrea Silvestre deSouza, Olga Ferreira deGibson, C. MichaelGranger, Christopher B.Alexander, John H.Lopes, Renato D.2022-06-21T17:35:47Z2022-06-21T17:35:47Z2022MACEDO, Ariane Vieira Scarlatelli et al. Discontinuing vs continuing ACEIs and ARBs in hospitalized patients with COVID-19 according to disease severity: Insights from the BRACE CORONA trial. American heart journal, v. 249, p. 86-97, 20220002-8703https://www.arca.fiocruz.br/handle/icict/5339310.1016/j.ahj.2022.04.001engElsevierDiscontinuing vs continuing ACEIs and ARBs in hospitalized patients with COVID-19 according to disease severity: Insights from the BRACE CORONA trialinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articleD'Or Institute for Research and Education. Rio de Janeiro, RJ, Brazil / Hospital São Luiz Jabaquara. São Paulo, SP, Brazil / Universidade Federal de São Paulo. Programa de Pós-Graduação em Medicina Translacional. São Paulo, SP, Brazil / Brazilian Clinical Research Institute. São Paulo, SP, Brazil.Brazilian Clinical Research Institute. São Paulo, SP, Brazil / Centro Universitário São Camilo. São Paulo, SP, Brazil.Hospital São Luiz Jabaquara. São Paulo, SP, Brazil / Brazilian Clinical Research Institute. São Paulo, SP, Brazil.D'Or Institute for Research and Education. Rio de Janeiro, RJ, Brazil.Brazilian Clinical Research Institute. São Paulo, SP, Brazil / Insper Institute of Education and Research. São Paulo, SP, Brazil.Brazilian Clinical Research Institute. São Paulo, SP, Brazil.D'Or Institute for Research and Education. Rio de Janeiro, RJ, Brazil / Hospital São Luiz Anália Franco. São Paulo, SP, Brazil.D'Or Institute for Research and Education. Rio de Janeiro, RJ, Brazil / Hospital São Luiz São Caetano. São Caetano do Sul, SP, Brazil.D'Or Institute for Research and Education. Rio de Janeiro, RJ, Brazil / Universidade do Estado do Rio de Janeiro. Rio de Janeiro, RJ, Brazil.Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Rio de Janeiro, RJ, Brasil / D'Or Institute for Research and Education. Rio de Janeiro, RJ, Brazil / Federal University of Rio de Janeiro. Rio de Janeiro, RJ, Brazil.D'Or Institute for Research and Education. Rio de Janeiro, RJ, Brazil / Rede D'Or São Luiz. São Paulo, SP, Brazil / Hospital Copa D'Or. Rio de Janeiro, RJ, Brazil.Harvard Medical School. Boston, MA, USA.Duke University Medical Center. Duke Clinical Research Institute. Durham, NC, USA.Duke University Medical Center. Duke Clinical Research Institute. Durham, NC, USA.D'Or Institute for Research and Education. Rio de Janeiro, RJ, Brazil / Universidade Federal de São Paulo. Programa de Pós-Graduação em Medicina Translacional. São Paulo, SP, Brazil / Brazilian Clinical Research Institute. São Paulo, SP, Brazil / Rede D'Or São Luiz. São Paulo, SP, Brazil / Duke University Medical Center. Duke Clinical Research Institute. Durham, NC, USA.Background: We explored the effect of discontinuing versus continuing angiotensin-converting enzyme inhibitors (ACEIs) and angiotensin II receptor blockers (ARBs) on clinical outcomes in patients with COVID-19 according to baseline disease severity. Methods: We randomized 659 patients with a confirmed diagnosis of COVID-19 and classified them as having mild or moderate COVID-19 disease severity at hospital presentation using blood oxygen saturation and lung imaging. The primary outcome was the mean ratio of number of days alive and out of the hospital at 30 days according to disease severity. Results: At presentation, 376 patients (57.1%) had mild and 283 (42.9%) had moderate COVID-19. In patients with mild disease, there was no significant difference in the number of days alive and out of the hospital between ACEI/ARB discontinuation (mean 23.5 [SD 6.3] days) and continuation (mean 23.8 [SD 6.5] days), with a mean ratio of 0.98 (95% CI 0.92-1.04). However, in patients with moderate disease, there were fewer days alive and out of the hospital with ACEI/ARB discontinuation (mean 19.6 [SD 9.5] days) than continuation (mean 21.6 [SD 7.6] days), with a mean ratio of 0.90 (95% CI 0.81-1.00; P-interaction = .01). The impact of discontinuing versus continuing ACEIs/ARBs on days alive and out of hospital through 30 days differed according to baseline COVID-19 disease severity. Conclusions: Unlike patients with mild disease, patients with moderate disease who continued ACEIs/ARBs had more days alive and out of hospital through 30 days than those who discontinued ACEIs/ARBs. This suggests that ACEIs/ARBs should be continued for patients with moderate COVID-19 disease severity.COVID-19Angiotensin-converting enzyme inhibitorsAngiotensin II receptor blockersinfo:eu-repo/semantics/openAccessreponame:Repositório Institucional da FIOCRUZ (ARCA)instname:Fundação Oswaldo Cruz (FIOCRUZ)instacron:FIOCRUZLICENSElicense.txtlicense.txttext/plain; charset=utf-83097https://www.arca.fiocruz.br/bitstream/icict/53393/1/license.txt73c2438d9038594f05d706f987b602c3MD51ORIGINALDiscontinuing_Andrea_Sousa_etal_INI_2022_COVID-19.pdfDiscontinuing_Andrea_Sousa_etal_INI_2022_COVID-19.pdfapplication/pdf1458350https://www.arca.fiocruz.br/bitstream/icict/53393/2/Discontinuing_Andrea_Sousa_etal_INI_2022_COVID-19.pdf58519df4ad8f311bec69dc2819a53a9fMD52icict/533932022-06-21 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dc.title.pt_BR.fl_str_mv Discontinuing vs continuing ACEIs and ARBs in hospitalized patients with COVID-19 according to disease severity: Insights from the BRACE CORONA trial
title Discontinuing vs continuing ACEIs and ARBs in hospitalized patients with COVID-19 according to disease severity: Insights from the BRACE CORONA trial
spellingShingle Discontinuing vs continuing ACEIs and ARBs in hospitalized patients with COVID-19 according to disease severity: Insights from the BRACE CORONA trial
Macedo, Ariane Vieira Scarlatelli
COVID-19
Angiotensin-converting enzyme inhibitors
Angiotensin II receptor blockers
title_short Discontinuing vs continuing ACEIs and ARBs in hospitalized patients with COVID-19 according to disease severity: Insights from the BRACE CORONA trial
title_full Discontinuing vs continuing ACEIs and ARBs in hospitalized patients with COVID-19 according to disease severity: Insights from the BRACE CORONA trial
title_fullStr Discontinuing vs continuing ACEIs and ARBs in hospitalized patients with COVID-19 according to disease severity: Insights from the BRACE CORONA trial
title_full_unstemmed Discontinuing vs continuing ACEIs and ARBs in hospitalized patients with COVID-19 according to disease severity: Insights from the BRACE CORONA trial
title_sort Discontinuing vs continuing ACEIs and ARBs in hospitalized patients with COVID-19 according to disease severity: Insights from the BRACE CORONA trial
author Macedo, Ariane Vieira Scarlatelli
author_facet Macedo, Ariane Vieira Scarlatelli
Barros E Silva, Pedro Gabriel Melo de
Paula, Thiago Ceccatto de
Moll-Bernardes, Renata Junqueira
Santos, Tiago Mendonça dos
Mazza, Lilian
Feldman, Andre
Arruda, Guilherme D. Andréa Saba
Albuquerque, Denílson Campos de
Sousa, Andrea Silvestre de
Souza, Olga Ferreira de
Gibson, C. Michael
Granger, Christopher B.
Alexander, John H.
Lopes, Renato D.
author_role author
author2 Barros E Silva, Pedro Gabriel Melo de
Paula, Thiago Ceccatto de
Moll-Bernardes, Renata Junqueira
Santos, Tiago Mendonça dos
Mazza, Lilian
Feldman, Andre
Arruda, Guilherme D. Andréa Saba
Albuquerque, Denílson Campos de
Sousa, Andrea Silvestre de
Souza, Olga Ferreira de
Gibson, C. Michael
Granger, Christopher B.
Alexander, John H.
Lopes, Renato D.
author2_role author
author
author
author
author
author
author
author
author
author
author
author
author
author
dc.contributor.author.fl_str_mv Macedo, Ariane Vieira Scarlatelli
Barros E Silva, Pedro Gabriel Melo de
Paula, Thiago Ceccatto de
Moll-Bernardes, Renata Junqueira
Santos, Tiago Mendonça dos
Mazza, Lilian
Feldman, Andre
Arruda, Guilherme D. Andréa Saba
Albuquerque, Denílson Campos de
Sousa, Andrea Silvestre de
Souza, Olga Ferreira de
Gibson, C. Michael
Granger, Christopher B.
Alexander, John H.
Lopes, Renato D.
dc.subject.en.pt_BR.fl_str_mv COVID-19
Angiotensin-converting enzyme inhibitors
Angiotensin II receptor blockers
topic COVID-19
Angiotensin-converting enzyme inhibitors
Angiotensin II receptor blockers
description D'Or Institute for Research and Education. Rio de Janeiro, RJ, Brazil / Hospital São Luiz Jabaquara. São Paulo, SP, Brazil / Universidade Federal de São Paulo. Programa de Pós-Graduação em Medicina Translacional. São Paulo, SP, Brazil / Brazilian Clinical Research Institute. São Paulo, SP, Brazil.
publishDate 2022
dc.date.accessioned.fl_str_mv 2022-06-21T17:35:47Z
dc.date.available.fl_str_mv 2022-06-21T17:35:47Z
dc.date.issued.fl_str_mv 2022
dc.type.status.fl_str_mv info:eu-repo/semantics/publishedVersion
dc.type.driver.fl_str_mv info:eu-repo/semantics/article
format article
status_str publishedVersion
dc.identifier.citation.fl_str_mv MACEDO, Ariane Vieira Scarlatelli et al. Discontinuing vs continuing ACEIs and ARBs in hospitalized patients with COVID-19 according to disease severity: Insights from the BRACE CORONA trial. American heart journal, v. 249, p. 86-97, 2022
dc.identifier.uri.fl_str_mv https://www.arca.fiocruz.br/handle/icict/53393
dc.identifier.issn.pt_BR.fl_str_mv 0002-8703
dc.identifier.doi.none.fl_str_mv 10.1016/j.ahj.2022.04.001
identifier_str_mv MACEDO, Ariane Vieira Scarlatelli et al. Discontinuing vs continuing ACEIs and ARBs in hospitalized patients with COVID-19 according to disease severity: Insights from the BRACE CORONA trial. American heart journal, v. 249, p. 86-97, 2022
0002-8703
10.1016/j.ahj.2022.04.001
url https://www.arca.fiocruz.br/handle/icict/53393
dc.language.iso.fl_str_mv eng
language eng
dc.rights.driver.fl_str_mv info:eu-repo/semantics/openAccess
eu_rights_str_mv openAccess
dc.publisher.none.fl_str_mv Elsevier
publisher.none.fl_str_mv Elsevier
dc.source.none.fl_str_mv reponame:Repositório Institucional da FIOCRUZ (ARCA)
instname:Fundação Oswaldo Cruz (FIOCRUZ)
instacron:FIOCRUZ
instname_str Fundação Oswaldo Cruz (FIOCRUZ)
instacron_str FIOCRUZ
institution FIOCRUZ
reponame_str Repositório Institucional da FIOCRUZ (ARCA)
collection Repositório Institucional da FIOCRUZ (ARCA)
bitstream.url.fl_str_mv https://www.arca.fiocruz.br/bitstream/icict/53393/1/license.txt
https://www.arca.fiocruz.br/bitstream/icict/53393/2/Discontinuing_Andrea_Sousa_etal_INI_2022_COVID-19.pdf
bitstream.checksum.fl_str_mv 73c2438d9038594f05d706f987b602c3
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bitstream.checksumAlgorithm.fl_str_mv MD5
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repository.name.fl_str_mv Repositório Institucional da FIOCRUZ (ARCA) - Fundação Oswaldo Cruz (FIOCRUZ)
repository.mail.fl_str_mv repositorio.arca@fiocruz.br
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