Evidence map›Paper›PMID 32302265›Full record

ArticleCirculation research2020

Association of Inpatient Use of Angiotensin-Converting Enzyme Inhibitors and Angiotensin II Receptor Blockers With Mortality Among Patients With Hypertension Hospitalized With COVID-19.

Peng Zhang, Lihua Zhu, Jingjing Cai, Fang Lei, Juan-Juan Qin, Jing Xie, Ye-Mao Liu, Yan-Ci Zhao, Xuewei Huang, Lijin Lin and 34 more

Erratum issued Registry-linked trialOpen access · bronzeAbstract readMulticenter Study
PubMed Full text at PMC Publisher
In one paragraph

Article in Circulation research, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. It is linked to trial NCT04508985 (Management of Renin-Angiotensin-Aldosterone System Blockade in Patients Admitted in Hospital With Confirmed Coronavirus Disease), which is not on this map. Cited by 661 papers, 11 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
661citing papers in PubMed, 11 pooled it
28.5field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT04508985 nacompletednot on this map

Management of Renin-Angiotensin-Aldosterone System Blockade in Patients Admitted in Hospital With Confirmed Coronavirus Disease (COVID-19) Infection: The McGill RAAS-COVID-19 Randomized Controlled Trial

TypeinterventionalSponsorMcGill University Health Centre/Research Institute of the McGill University Health CentreRan2020 to 2021Enrolled46ConditionsCOVID-19, Cardiovascular DiseasesArmsTemporarily holding the RAAS inhibitor [intervention], RAAS inhibitor [continued standard of care]
3 · Its place in the literature

Who cites it

661 citing papers in PubMed, 11 syntheses or guidelines pooled it, 1,181 citations in OpenAlex.

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  17. Response to: Do angiotensin-converting enzyme inhibitors not reduce the risk of pneumonia?Hypertension research : official journal of the Japanese Society of Hypertension · 2025
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601 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

44 authors at 15 institutions in 5 countries.

Peng Zhang *From the Cardiology (P.Z., L.Z., J.-J.Q., J. Xie, Y.-M.L., Y.-C.Z., X. Huang, M.-M.C., X.C., Z.-G.S., X.-J.Z., H.L.), Renmin Hospital of Wuhan University.
Lihua Zhu *From the Cardiology (P.Z., L.Z., J.-J.Q., J. Xie, Y.-M.L., Y.-C.Z., X. Huang, M.-M.C., X.C., Z.-G.S., X.-J.Z., H.L.), Renmin Hospital of Wuhan University.
Jingjing Cai *Cardiology, The Third Xiangya Hospital, Central South University, Changsha, China (J. Cai).
Fang Lei *Institute of Model Animal of Wuhan University (P.Z., L.Z., F.L., J.-J.Q., Y.-M.L., Y.-C.Z., X. Huang, L. Lin, M.X., M.-M.C., X.C., Y.-X.J., J. Chen, Z.-G.S., X.-J.Z., H.L.).
Juan-Juan Qin *From the Cardiology (P.Z., L.Z., J.-J.Q., J. Xie, Y.-M.L., Y.-C.Z., X. Huang, M.-M.C., X.C., Z.-G.S., X.-J.Z., H.L.), Renmin Hospital of Wuhan University.
Jing XieFrom the Cardiology (P.Z., L.Z., J.-J.Q., J. Xie, Y.-M.L., Y.-C.Z., X. Huang, M.-M.C., X.C., Z.-G.S., X.-J.Z., H.L.), Renmin Hospital of Wuhan University.
Ye-Mao LiuFrom the Cardiology (P.Z., L.Z., J.-J.Q., J. Xie, Y.-M.L., Y.-C.Z., X. Huang, M.-M.C., X.C., Z.-G.S., X.-J.Z., H.L.), Renmin Hospital of Wuhan University.
Yan-Ci ZhaoFrom the Cardiology (P.Z., L.Z., J.-J.Q., J. Xie, Y.-M.L., Y.-C.Z., X. Huang, M.-M.C., X.C., Z.-G.S., X.-J.Z., H.L.), Renmin Hospital of Wuhan University.
Xuewei HuangFrom the Cardiology (P.Z., L.Z., J.-J.Q., J. Xie, Y.-M.L., Y.-C.Z., X. Huang, M.-M.C., X.C., Z.-G.S., X.-J.Z., H.L.), Renmin Hospital of Wuhan University.
Lijin LinInstitute of Model Animal of Wuhan University (P.Z., L.Z., F.L., J.-J.Q., Y.-M.L., Y.-C.Z., X. Huang, L. Lin, M.X., M.-M.C., X.C., Y.-X.J., J. Chen, Z.-G.S., X.-J.Z., H.L.).
Meng XiaInstitute of Model Animal of Wuhan University (P.Z., L.Z., F.L., J.-J.Q., Y.-M.L., Y.-C.Z., X. Huang, L. Lin, M.X., M.-M.C., X.C., Y.-X.J., J. Chen, Z.-G.S., X.-J.Z., H.L.).
Ming-Ming ChenFrom the Cardiology (P.Z., L.Z., J.-J.Q., J. Xie, Y.-M.L., Y.-C.Z., X. Huang, M.-M.C., X.C., Z.-G.S., X.-J.Z., H.L.), Renmin Hospital of Wuhan University.
Xu ChengFrom the Cardiology (P.Z., L.Z., J.-J.Q., J. Xie, Y.-M.L., Y.-C.Z., X. Huang, M.-M.C., X.C., Z.-G.S., X.-J.Z., H.L.), Renmin Hospital of Wuhan University.
Xiao ZhangEye Center (X.Z.), Renmin Hospital of Wuhan University.
Deliang GuoHepatobiliary and Pancreatic Surgery (D.G., H.W., Y. Yuan), Zhongnan Hospital of Wuhan University.
Yuanyuan PengCardiology (Y.P.), Zhongnan Hospital of Wuhan University.
Yan-Xiao JiMedical Science Research Center (P.Z., Y.-X.J., H.L.), Zhongnan Hospital of Wuhan University.
Jing ChenInstitute of Model Animal of Wuhan University (P.Z., L.Z., F.L., J.-J.Q., Y.-M.L., Y.-C.Z., X. Huang, L. Lin, M.X., M.-M.C., X.C., Y.-X.J., J. Chen, Z.-G.S., X.-J.Z., H.L.).
Zhi-Gang SheFrom the Cardiology (P.Z., L.Z., J.-J.Q., J. Xie, Y.-M.L., Y.-C.Z., X. Huang, M.-M.C., X.C., Z.-G.S., X.-J.Z., H.L.), Renmin Hospital of Wuhan University.
Yibin WangAnesthesiology, Cardiovascular Research Laboratories, David Geffen School of Medicine, University of California, Los Angeles (Y.W.).
Qingbo XuCentre for Clinic Pharmacology, The William Harvey Research Institute, Queen Mary University of London, United Kingdom (Q.X.).
Renfu TanWuhan Kanghuashuhai Technology Company (R.T.), Wuhan.
Haitao WangHepatobiliary and Pancreatic Surgery (D.G., H.W., Y. Yuan), Zhongnan Hospital of Wuhan University.
Jun LinGastroenterology (J.L.), Zhongnan Hospital of Wuhan University.
Pengcheng LuoUrology (P.L.), Wuhan Third Hospital & Tongren Hospital of Wuhan University.
Shouzhi FuIntensive Care Unit (S.F.), Wuhan Third Hospital & Tongren Hospital of Wuhan University.
Hongbin CaiWuhan Ninth Hospital (H.C., M.L.).
Ping YeCardiology, The Central Hospital of Wuhan (P.Y., M.C.).
Bing XiaoStomatology, Xiantao First People's Hospital (B.X.).
Weiming MaoGeneral Surgery, Huanggang Central Hospital, Wuhan, China (W.M.).
Liming LiuGeneral Surgery, Ezhou Central Hospital (L. Liu).
Youqin YanInfections Department, Wuhan Seventh Hospital (Y. Yan).
Mingyu LiuWuhan Ninth Hospital (H.C., M.L.).
Manhua ChenCardiology, The Central Hospital of Wuhan (P.Y., M.C.).
Xiao-Jing ZhangFrom the Cardiology (P.Z., L.Z., J.-J.Q., J. Xie, Y.-M.L., Y.-C.Z., X. Huang, M.-M.C., X.C., Z.-G.S., X.-J.Z., H.L.), Renmin Hospital of Wuhan University.
Xinghuan WangCenter for Evidence-Based and Translational Medicine (X.W.), Zhongnan Hospital of Wuhan University.
Rhian M TouyzInstitute of Cardiovascular and Medical Sciences, BHF Glasgow Cardiovascular Research Centre, University of Glasgow, United Kingdom (R.M.T.).
Jiahong XiaCardiovascular Surgery, Union Hospital (J.Xia), Tongji Medical College, Huazhong University of Science and Technology.
Bing-Hong ZhangNeonatology (B.-H.Z.), Renmin Hospital of Wuhan University.
Xiaodong HuangGastroenterology (X.H.), Wuhan Third Hospital & Tongren Hospital of Wuhan University.
Yufeng YuanHepatobiliary and Pancreatic Surgery (D.G., H.W., Y. Yuan), Zhongnan Hospital of Wuhan University.
Rohit LoombaNAFLD Research Center, Division of Gastroenterology and Epidemiology, University of California San Diego, CA (L.R.).
Peter P LiuDivision of Cardiology, Department of Medicine, University of Ottawa Heart Institute, Ontario, Canada (P.P.L.).
Hongliang LiFrom the Cardiology (P.Z., L.Z., J.-J.Q., J. Xie, Y.-M.L., Y.-C.Z., X. Huang, M.-M.C., X.C., Z.-G.S., X.-J.Z., H.L.), Renmin Hospital of Wuhan University.
Wuhan University · CNSoochow University · CNTongren Hospital · CNCentral Hospital of Wuhan · CNCentral South University · CNHuanggang Central Hospital · CNHuazhong University of Science and Technology · CNLiuzhou General Hospital · CNQueen Mary University of London · GBUniversity of California, Los Angeles · USUniversity of California San Diego · USUniversity of Glasgow · GBUniversity of Ottawa · CAWuhan No. 7 Hospital · CNXiaogan First People's Hospital · CN

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

rationaleUse of ACEIs (angiotensin-converting enzyme inhibitors) and ARBs (angiotensin II receptor blockers) is a major concern for clinicians treating coronavirus disease 2019 (COVID-19) in patients with hypertension.

objectiveTo determine the association between in-hospital use of ACEI/ARB and all-cause mortality in patients with hypertension and hospitalized due to COVID-19. METHODS AND

resultsThis retrospective, multi-center study included 1128 adult patients with hypertension diagnosed with COVID-19, including 188 taking ACEI/ARB (ACEI/ARB group; median age 64 [interquartile range, 55-68] years; 53.2% men) and 940 without using ACEI/ARB (non-ACEI/ARB group; median age 64 [interquartile range 57-69]; 53.5% men), who were admitted to 9 hospitals in Hubei Province, China from December 31, 2019 to February 20, 2020. In mixed-effect Cox model treating site as a random effect, after adjusting for age, gender, comorbidities, and in-hospital medications, the detected risk for all-cause mortality was lower in the ACEI/ARB group versus the non-ACEI/ARB group (adjusted hazard ratio, 0.42 [95% CI, 0.19-0.92];

conclusionsAmong hospitalized patients with COVID-19 and coexisting hypertension, inpatient use of ACEI/ARB was associated with lower risk of all-cause mortality compared with ACEI/ARB nonusers. While study interpretation needs to consider the potential for residual confounders, it is unlikely that in-hospital use of ACEI/ARB was associated with an increased mortality risk.

Indexed as

Hospital MortalityAgedAngiotensin-Converting Enzyme InhibitorsAngiotensin Receptor AntagonistsCoronavirus InfectionsCOVID-19FemaleHumansHypertensionInpatientsMaleMiddle AgedPandemicsPneumonia, ViralAngiotensin-Converting Enzyme InhibitorsAngiotensin Receptor Antagonistsangiotensin-converting enzyme inhibitorangiotensin II receptor blockercoronavirusCOVID-19hypertensioninpatients

Identifiers

PMID32302265
PMCPMC7265882
OpenAlexW3016572296

What Socratic holds

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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.