ReviewJournal of hypertension2021
Evaluating sources of bias in observational studies of angiotensin-converting enzyme inhibitor/angiotensin II receptor blocker use during COVID-19: beyond confounding.
Review in Journal of hypertension, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 35 papers.
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.
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.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
35 citing papers in PubMed, 47 citations in OpenAlex.
- Efficacy of Losartan in Hospitalized Patients With COVID-19-Induced Lung Injury: A Randomized Clinical Trial.JAMA network open · 2022Trial
- Estimating the association of hypertensive disorders of pregnancy with offspring kidney function from adolescence into young adulthood.Pediatric nephrology (Berlin, Germany) · 2026Article
- Disordered eating among military adolescents presenting for annual health visits at a naval clinic.Eating behaviors · 2025Article
- The Study of the Epidemiology of Pediatric Hypertension Registry (SUPERHERO): rationale and methods.American journal of epidemiology · 2024Article
- Risk of Obesity and Unhealthy Central Adiposity in Adolescents Born Preterm With Very Low Birthweight Compared to Term-Born Peers.Childhood obesity (Print) · 2024Article
- Human immune and metabolic biomarker levels, and stress-biomarker associations, differ by season: Implications for biomedical health research.Brain, behavior, & immunity - health · 2024Article
- Uric Acid Is Not Associated With Cardiovascular Health in Youth With Type 1 Diabetes: SEARCH for Diabetes in Youth Study.The Journal of clinical endocrinology and metabolism · 2024Article
- Methodological biases in observational hospital studies of COVID-19 treatment effectiveness: pitfalls and potential.Frontiers in medicine · 2024Article
- Duration of Simultaneous Exposure to High-Risk and Lower-Risk Nephrotoxic Antimicrobials in the Neonatal Intensive Care Unit (NICU) and Future Adolescent Kidney Health.The Journal of pediatrics · 2024Article
- Prevalence and risk factors of disordered eating behavior in youth with hypertension disorders.Pediatric nephrology (Berlin, Germany) · 2023Article
- Association of antenatal corticosteroids with kidney function in adolescents born preterm with very low birth weight.Journal of perinatology : official journal of the California Perinatal Association · 2023Article
- Appraising the Preclinical Evidence of the Role of the Renin-Angiotensin-Aldosterone System in Antenatal Programming of Maternal and Offspring Cardiovascular Health Across the Life Course: Moving the Field Forward: A Scientific Statement From the American Heart Association.Hypertension (Dallas, Tex. : 1979) · 2023Review
- Target Trial Emulation Using Hospital-Based Observational Data: Demonstration and Application in COVID-19.Life (Basel, Switzerland) · 2023Article
- Growth During Infancy After Extremely Preterm Birth: Associations with Later Neurodevelopmental and Health Outcomes.The Journal of pediatrics · 2023Article
- Long-term kidney function recovery and mortality after COVID-19-associated acute kidney injury: An international multi-centre observational cohort study.EClinicalMedicine · 2023Article
- Antenatal Programming of Hypertension: Paradigms, Paradoxes, and How We Move Forward.Current hypertension reports · 2022Review
- Association of kidney function with posterior reversible encephalopathy syndrome in children.Clinical nephrology · 2022Article
- Article
- Distinguishing Admissions Specifically for COVID-19 From Incidental SARS-CoV-2 Admissions: National Retrospective Electronic Health Record Study.Journal of medical Internet research · 2022Article
- Correlation between kidney sodium and potassium handling and the renin-angiotensin-aldosterone system in children with hypertensive disorders.Pediatric nephrology (Berlin, Germany) · 2022Article
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Authors and funding
5 authors at 3 institutions in 1 country.
Funding
Abstract
Concerns over ACE inhibitor or ARB use to treat hypertension during COVID-19 remain unresolved. Although studies using more robust methodologies provided some clarity, sources of bias persist and it remains critical to quickly address this question. In this review, we discuss pernicious sources of bias using a causal model framework, including time-varying confounder, collider, information, and time-dependent bias, in the context of recently published studies. We discuss causal inference methodologies that can address these issues, including causal diagrams, time-to-event analyses, sensitivity analyses, and marginal structural modeling. We discuss effect modification and we propose a role for causal mediation analysis to estimate indirect effects via mediating factors, especially components of the renin--angiotensin system. Thorough knowledge of these sources of bias and the appropriate methodologies to address them is crucial when evaluating observational studies to inform patient management decisions regarding whether ACE inhibitors or ARBs are associated with greater risk from COVID-19.
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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.