Effect of ACE Inhibitor Therapy on Mortality in COVID-19 Patients with Hypertension: Meta-Analysis
AbstractBackground: Acute respiratory syndrome Corona Virus 2 (SARS-CoV-2) can trigger the occurrence of respiratory infectious disease Coronavirus Disease 2019 (COVID-19). Patients who have comorbid health problems such as hypertension, chronic liver, cardiovascular and diabetes mellitus are more likely to experience deterioration and death. ACE inhibitor therapy in patients with hypertension has a therapeutic effect in lowering blood pressure and is able to reduce mortality rates in COVID-19 patients, but the benefits of ACE inhibitors in patients with COVID-19 are still uncertain. This study aims to determine how much influence ACE inhibitors have on COVID-19 patients with hypertension on mortality rates.Subjects and Method: This study is a systematic review and meta-analysis with the following PICO, population: COVID-19 patients with hypertension. Intervention: administration of ACE inhibitor therapy. Comparison: therapy other than ACE inhibitors. Outcome: mortality. The articles used in this study were obtained from several online databases, including Science Direct, PubMed and Google Scholar. The keywords used in the article search were:
Albini A, Guardo GD, Noonan MC, Lombardo M (2020). The SARS-CoV-2 receptor, ACE-2, is expressed on many different cell types: implications for ACE-inhibitor- and angio-tensin II receptor blocker-based cardiovascular therapies. Intern Emerg Med. 15(5): 759
Bauer AZ, Gore R, Sama SR, Rosiello R, Garber L, Sundaresan D, McDonald A, et al. (2021). Hypertension, medications, and risk of severe COVID-19: A Massachusetts community-based observational study. J. Clin. Hypertens. 23(1): 21
Huang I, Lim MA, Pranata R (2020). Diabetes mellitus is associated with increased mortality and severity of disease in COVID-19 pneumonia
Jiofansyah M (2020). Angiotensin converting enzyme inhibitor sebagai terapi pasien hipertensi primer dengan obesitas. JIMKI. 7(2): 147
Lam KW, Chow KW, Vo J, Hou W, Li H, Richman PS, Mallipattu SK, et al. (2020). Continued in-hospital angiotensin-converting enzyme inhibitor and angiotensin II receptor blocker use in hypertensive COVID-19 patients is associated with positive clinical outcome. J. Infect. Dis. 222(8): 1256
Polverino F, Stern DA, Ruocco G, Balestro E, Bassetti M, Candelli M, Cirillo B, et al. (2020). Comorbidities, cardiovascular therapies, and COVID-19 mortality: A nationwide, italian observational study (ItaliCO). Front. cardiovasc. med. 7. 1
Singh AK, Gupta R, Misra A (2020). Comorbidities in COVID-19: Outcomes in hypertensive cohort and controversies with renin angiotensin system blockers. Diabetes Metab. Syndr.: Clin. Res. Rev. 14(4): 283
Susilo A, Rumende MC, Pitoyo CW, Santoso WD, Yulianti M, Herikurniawan, Sinto R, et al. (2020). Coronavirus Disease 2019: Tinjauan literatur terkini (Coronavirus Disease 2019: Recent Literature Review). J. penyakit dalam Indones. 7(1): 45. doi: 10.7454/jpdi.v7i1.415.
Yan F, Huang F, Xu J, Yang P, Qin Y, Lv J, Zhang S, et al. (2020). Antihypertensive drugs are associated with reduced fatal outcomes and improved clinical characteristics in elderly COVID-19 patients. Cell Discov. 6(1). doi: 10.1038/s41421-020-00221-6.
Yang G, Tan Z, Zhou L, Yang M, Peng L,Liu J, Cai J, et al. (2020). Effects of angiotensin II receptor blockers and ACE (Angiotensin-Converting Enzyme) inhibitors on virus infection, inflammatory status, and clinical outcomes in patients with COVID-19 and Hypertension: A single-center retrospective study. Hypertension. 76(1): 51
Yonata A, Pratama ASP (2016). Hipertensi sebagai faktor pencetus terjadinya stroke (Hypertension as a trigger factor for stroke). Jurnal Majority. 5(3): 17