Discontinuing vs continuing ACEIs and ARBs in hospitalized patients with COVID-19 according to disease severity: Insights from the BRACE CORONA trial
| Autor(a) principal: | |
|---|---|
| Data de Publicação: | 2022 |
| Outros Autores: | , , , , , , , , , , , , , |
| Tipo de documento: | Artigo |
| Idioma: | eng |
| Título da fonte: | Repositório Institucional da FIOCRUZ (ARCA) |
| Texto Completo: | https://www.arca.fiocruz.br/handle/icict/53393 |
Resumo: | 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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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 |
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COVID-19 Angiotensin-converting enzyme inhibitors Angiotensin II receptor blockers |
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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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2022 |
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2022-06-21T17:35:47Z |
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2022-06-21T17:35:47Z |
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2022 |
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info:eu-repo/semantics/article |
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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 |
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0002-8703 |
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10.1016/j.ahj.2022.04.001 |
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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 |
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Elsevier |
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