Effect of Angiotensin-Converting Enzyme Inhibitors or Angiotensin II Receptor Blockers on Prognosis in COVID-19 Patients

Objectives: Studies suggest that Coronavirus Disease 2019 (COVID-19) may enter the human body via the angiotensin-converting enzyme 2 (ACE2) receptor, and that the use of renin-angiotensin system (RAS) blockers could increase ACE2 receptor expression.We aimed to investigate the effects of angiotensin-converting enzyme inhibitors (ACEIs) and angiotensin receptor blockers (ARBs) on the prognosis of COVID-19 patients with hypertension.Methods: This retrospective, single-center study included 1,130 hospitalized patients aged 18 and over who were diagnosed with COVID-19 via a positive PCR test or based on chest CT radiological findings between March 15, 2020, and July 1, 2021.Patients were divided into two groups: those with and without hypertension.Additionally, hypertensive patients were further categorized based on ACEI/ARB usage to evaluate the impact of these medications on disease prognosis.Statistical analyses were performed using SPSS Statistics 22. Results:The study included 511 (45%) female and 619 (55%) male patients.The prevalence of hypertension was significantly higher in patients admitted to the intensive care unit compared to those in the ward (63% vs. 41%; p<0.001;OR: 2.51; CI: 1.73-3.65).Similarly, hypertension was more prevalent among deceased patients than among those discharged (68% vs. 40%; p<0.001;OR: 2.9; CI: 1.99-4.21).Regression analysis revealed that ACEI/ARB use did not significantly affect mortality.Among biochemical parameters, a significant difference was observed only in CRP levels between ACEI/ARB users and non-users (7.199.75 vs. 8.7410.18;p=0.032). Conclusion:No adverse effects of ACEI/ARB use on COVID-19 outcomes were observed.ACEIs and ARBs, which are primary agents in the treatment of coronary artery disease, heart failure, diabetes, and hypertension, can be safely used in patients with COVID-19.