Inhibition of Renin-angiotensin System and Clinical Outcomes of COVID-19

COVID-19 is an acute respiratory illness caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). A few studies with conflicting results have been performed to evaluate the relationship between the use of angiotensin system inhibitors and COVID-19 outcomes. Therefore, this study was performed to compare the clinical and paraclinical characteristics of patients with COVID-19 in two groups of patients treated with angiotensin-converting enzyme inhibitors (ACEIs)/angiotensin receptor blockers (ARBs) and the control group (no history of ACEIs/ARBs) in Kamkar and Shahid Beheshti hospitals in Qom City, Iran from March 14, 2019, to the end of September 21, 2020.

This retrospective descriptive study was performed by reviewing the medical record of 359 patients with COVID-19, which was confirmed by a physician via lung scan or reverse transcription polymerase chain reaction (RT-PCR). We used the independent t test to compare quantitative variables and the Chi-square test to analyze qualitative variables.

The common clinical symptoms, number of hospitalization days, oxygen saturation, and lung involvement were not significantly different between the two groups. Weakness, nausea, and sweating were significantly reduced in the control group compared to the ACEIs/ARBs group (P<0.05). Regarding the biochemical study, the patients’ hemoglobin levels and lymphocyte count on the first day of hospitalization in the ACEIs/ARBs group were significantly lower than the control (P<0.05)

These findings do not provide evidence of adverse or beneficial effects of angiotensin system inhibitors, so we require more detailed studies with a larger sample size.