Retrospective analysis of clinical outcomes of patients with COVID-19 depending on receiving antihypertensive, lipid-lowering and antihypertensive therapy
- Authors: Demidova T.Y.1, Lobanova K.G.1, Perekhodov S.N.2, Antsiferov M.B.3, Oynotkinova O.S.1
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Affiliations:
- Pirogov Russian National Research Medical University
- Demikhov Clinical City Hospital
- Endocrinological Dispensary
- Issue: Vol 93, No 10 (2021)
- Pages: 1193-1202
- Section: Original articles
- URL: https://journals.rcsi.science/0040-3660/article/view/86950
- DOI: https://doi.org/10.26442/00403660.2021.10.201072
- ID: 86950
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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.
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##article.viewOnOriginalSite##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, MoscowKristina 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, MoscowSergey 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, MoscowMichail B. Antsiferov
Endocrinological Dispensary
Email: miss.sapog@mail.ru
ORCID iD: 0000-0002-9944-2997
д-р мед. наук, проф., глав. врач
Russian Federation, MoscowOlga 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, MoscowReferences
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