Seniors with COVID-19 taking ACE inhibitors have lower hospitalization risk

A Yale-led study suggests that older COVID-19 patients taking ACE inhibitors for hypertension have a lower risk of hospitalization for the novel coro rus.

The study is posted on the medical pre-print website medRxiv  and has been submitted for peer-reviewed publication.

Researchers analyzed retrospective data from about 10,000 patients with hypertension who tested positive for SARS-CoV-2, the virus that causes COVID-19. All patients were enrolled in either Medicare Advantage or a commercially insured health care plan and had a prescription for at least one hypertension medication, such as angiotensin-converting enzyme (ACE) inhibitors or angiotensin receptor blockers (ARB).

The use of ACE inhibitors was associated with an almost 40% lower risk of COVID-19 hospitalization for the older, Medicare Advantage patients - but there was no significant difference in risk for the younger, commercially insured patients.

The use of ARBs was not associated with a lower risk for COVID-19 hospitalization for either group. Also, neither ARBs nor ACE inhibitors were associated with a lower mortality risk in people hospitalized with COVID-19.

" While not yet actionable, these findings provide an impetus to test whether this common, inexpensive class of drugs can mitigate the impact of the virus," said  Dr. Harlan Krumholz , the Harold H. Hines Jr. Professor of Medicine at Yale and director of the Yale New Haven Hospital Center for Outcomes Research.

Krumholz is co-senior author of the study, along with Dr. Deneen Vojta, executive director of research and development for the Minnesota-based company UnitedHealth Group. Krumholz said a large-scale clinical trial is being prepared to examine the potential role of ACE inhibitors in preventing the most severe consequences of COVID-19.

The researchers said the study was prompted by unresolved gaps in scientific knowledge that have led to debate over how ACE inhibitors and ARBs affect COVID-19 patients.

Dr. Rohan Khera, who will be joining Yale later this year from the University of Texas Southwestern, is co-first author of the study. Yale co-authors are  Yuan Lu ,  Erica Spatz ,  Karthik Murugiah ,  Zhenqiu Lin , and  Saad Omer.

UnitedHealth Group funded the research.

Jim Shelton

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