Retrospective analysis of clinical outcomes of patients with COVID-19 depending on receiving antihypertensive, lipid-lowering and antihypertensive therapy

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Abstract

Background. The main factors that increase the risk of cardiovascular accidents and mortality among patients with COVID-19 include hyperglycemia, arterial hypertension and dyslipidemia. Therefore, all patients with COVID-19 and metabolic syndrome should receive antihypertensive (AHT), hypolipidemic (GLT) and hypoglycemic therapy (GGT). Currently, there is a limited number of studies regarding the effectiveness and safety of this therapy in patients with COVID-19.

Aim. Evaluate the clinical outcomes of patients with COVID-19, depending on the recipient of AHT, GLT and GGT.

Materials and methods. A retrospective analysis of the clinical outcomes "discharged/died" of 1753 patients with COVID-19 was carried out depending on the received AHT, GLT and GGT.

Results. A significant reduction in the risk of mortality among patients with COVID-19 was observed during therapy with angiotensin-converting enzyme inhibitors/angiotensin II receptor blockers – ACE inhibitors/ARBs (OR 0.39, 95% CI 0.21–0.72; p<0.05) and b-adrenergic blockers – b-AB (OR 0.53, 95% CI 0.28–1; p<0.05). At the same time, against the background of therapy with ACE inhibitors/ARBs and b-ABs, the chance of mortality decreased more significantly among patients with type 2 diabetes mellitus (T2DM) compared with patients without T2DM. Diuretic therapy was associated with a 3-fold increase in the chances of death: OR 3.33, 95% CI 1.88–4.79; p<0.05. Statin therapy did not affect clinical outcomes in COVID-19 patients. On the background of therapy with oral hypoglycemic drugs, the risk of mortality decreased 5-fold (OR 0.19, 95% CI 0.07–0.54; p<0.05). Against the background of insulin therapy, there was an increase in mortality risk by 2.8 times (OR 2.81, 95% CI 1.5–5.29; p<0.05).

Conclusion. A significant reduction in mortality among patients with COVID-19 was observed during therapy with ACEI/ARB, b-AB, and oral hypoglycemic therapy. Increased risk of death was associated with insulin therapy and diuretic therapy.

About the authors

Tatiana Yu. Demidova

Pirogov Russian National Research Medical University

Email: miss.sapog@mail.ru
ORCID iD: 0000-0001-6385-540X

д-р мед. наук, проф., зав. каф. эндокринологии лечебного фак-та

Russian Federation, Moscow

Kristina G. Lobanova

Pirogov Russian National Research Medical University

Author for correspondence.
Email: miss.sapog@mail.ru
ORCID iD: 0000-0002-3656-0312

ассистент каф. эндокринологии лечебного фак-та

Russian Federation, Moscow

Sergey N. Perekhodov

Demikhov Clinical City Hospital

Email: miss.sapog@mail.ru
ORCID iD: 0000-0002-6276-2305

д-р мед. наук, проф., глав. врач

Russian Federation, Moscow

Michail B. Antsiferov

Endocrinological Dispensary

Email: miss.sapog@mail.ru
ORCID iD: 0000-0002-9944-2997

д-р мед. наук, проф., глав. врач

Russian Federation, Moscow

Olga S. Oynotkinova

Pirogov Russian National Research Medical University

Email: miss.sapog@mail.ru
ORCID iD: 0000-0002-9856-8643

д-р мед. наук, проф. каф. пропедевтики внутренних болезней и лучевой медицины лечебного фак-та

Russian Federation, Moscow

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Supplementary files

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1. JATS XML
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2. Fig. 1. Mortality of patients with COVID-19, depending on receiving antihypertensive and lipid-lowering therapy

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3. Fig. 2. Mortality of patients with COVID-19 and T2DM depending on antihyperglycemic therapy (%).

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4. Fig. 3. The likelihood of developing outcomes of recovery/death, depending on the therapy received.

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5. Fig. 4. The likelihood of developing outcomes "recovery/death" depending on the received antihyperglycemic therapy.

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