Renin-angiotensin system inhibition and risk of infection and mortality in COVID-19: a systematic review and meta-analysis.

Abstract:

BACKGROUND:Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the causative agent of COVID-19, enters human cells by binding of its viral protein to the aminopeptidase angiotensin-converting enzyme 2 (ACE2). This has led to speculation whether treatment with renin-angiotensin system (RAS) inhibitors was associated with an increased likelihood of a positive test for COVID-19 and risk of mortality. AIMS:We performed a systematic review and meta-analysis to investigate whether RAS inhibitors increased the likelihood of a positive test or death/severe illness in patients with COVID-19. METHODS:A systematic search of MEDLINE, PubMed and EMBASE was conducted for studies stratified by the use of angiotensin-converting enzyme inhibitors (ACEI) or angiotensin receptor blockers (ARB). Pooled analysis was performed using a random-effects model. RESULTS:Seven trials of 73 122 patients were included. Overall, 16 624 (22.7%) patients had a positive COVID-19 test and 7892 (10.8%) were on a RAS inhibitor. RAS inhibitors were not associated with higher likelihood of a positive COVID-19 test result (odds ratio (OR) 0.97 (95% CI 0.97-1.05, P = 0.48) with low heterogeneity. This was comparable when stratifying by use of each medication class. The use of RAS inhibitors was also not associated with mortality or severe illness (OR 0.89, 95% CI 0.73-1.07, P = 0.21) with moderate heterogeneity. CONCLUSION:Use of ACEI or ARB was not associated with a heightened susceptibility for a positive diagnosis of COVID-19. Furthermore, they were not associated with increased illness severity or mortality due to COVID-19. Randomised controlled trials are needed to address definitively the potential benefits or harms of RAS inhibitors in patients with COVID-19.

journal_name

Intern Med J

authors

Koshy AN,Murphy AC,Farouque O,Ramchand J,Burrell LM,Yudi MB

doi

10.1111/imj.15002

subject

Has Abstract

pub_date

2020-12-01 00:00:00

pages

1468-1474

issue

12

eissn

1444-0903

issn

1445-5994

journal_volume

50

pub_type

杂志文章,meta分析
  • Prospective randomised trial of endobronchial ultrasound-guide sheath versus computed tomography-guided percutaneous core biopsies for peripheral lung lesions.

    abstract:AIM:To determine diagnostic rate, complications and patient tolerability of endobronchial ultrasound-guide sheath (EBUS-GS) and computed tomography (CT)-guided percutaneous core biopsy for peripheral lung lesions. METHODS:Lesions >1 cm diameter on CT were randomised to either EBUS-GS or CT-guided biopsy. Excluded were...

    journal_title:Internal medicine journal

    pub_type: 杂志文章,随机对照试验

    doi:10.1111/j.1445-5994.2011.02707.x

    authors: Fielding DI,Chia C,Nguyen P,Bashirzadeh F,Hundloe J,Brown IG,Steinke K

    更新日期:2012-08-01 00:00:00

  • Population-based analysis of radiotherapy and chemotherapy treatment in the last month of life within regional Australia.

    abstract:BACKGROUND:Cancer treatment near end of life is not likely to add meaningful benefit and minimising intervention rates has been promoted as an indicator of quality of care. Population-based analysis of treatment allows comparative analysis of treatment rates and provides insight into patterns of care. AIMS:To report a...

    journal_title:Internal medicine journal

    pub_type: 杂志文章

    doi:10.1111/imj.14377

    authors: Pitson G,Matheson L,Garrard B,Eastman P,Rogers M

    更新日期:2020-05-01 00:00:00

  • Young onset dementia.

    abstract::Young onset dementia (YOD), where symptoms of dementia have an onset before the age of 65, has become more prominent due to the population increase from the Baby Boomer generation. This clinical perspective examines key issues in the assessment, diagnosis and management of YOD. Challenges in the assessment and diagnos...

    journal_title:Internal medicine journal

    pub_type: 杂志文章

    doi:10.1111/imj.13099

    authors: Draper B,Withall A

    更新日期:2016-07-01 00:00:00

  • Selecting haematological malignancy patients for intravenous immunoglobulin.

    abstract::Prior randomised studies of immunoglobulin replacement therapy have studied mixed populations with or without a history of infections. Immunoglobulin therapy is expensive and in limited supply suggesting that optimising patient selection is of value. In this retrospective study, infection history identified high-risk ...

    journal_title:Internal medicine journal

    pub_type: 杂志文章

    doi:10.1111/imj.13205

    authors: Paxton L,Hawkins C,Crispin P

    更新日期:2016-10-01 00:00:00

  • Inflammatory bowel disease incidence, prevalence and 12-month initial disease course in Tasmania, Australia.

    abstract:BACKGROUND:High inflammatory bowel disease (IBD) rates have been reported in Australasia, but no state-wide studies have yet been performed. AIM:This study estimates the 1-year incidence and point prevalence of IBD in the state of Tasmania, Australia. It also reports clinical outcomes after 12 months of diagnosis in a...

    journal_title:Internal medicine journal

    pub_type: 杂志文章

    doi:10.1111/imj.14111

    authors: Bhatia R,Yeoh SW,Vaz K,Studd C,Wilson J,Bell S,Otahal P,Venn A

    更新日期:2019-05-01 00:00:00

  • Clinical audit: virological and immunological response to combination antiretroviral therapy in HIV patients at a Sydney sexual health clinic.

    abstract:AIM:Bigge Park Centre (BPC) is a sexual health clinic located in a socially disadvantaged area in Southwest Sydney. This served as a retrospective clinical audit, documenting patient demographics, identifying factors associated with virological, immunological and discordant responses, evaluating the centre's ability in...

    journal_title:Internal medicine journal

    pub_type: 杂志文章

    doi:10.1111/j.1445-5994.2009.01983.x

    authors: Hsu DC,Quin JW

    更新日期:2010-04-01 00:00:00

  • Complete recovery from paraparesis in spinal cord compression due to extramedullary haemopoiesis in beta-thalassaemia by emergency radiation therapy.

    abstract::Extramedullary haemopoiesis (EMH) is a complication commonly associated with beta-thalassaemia intermedia; it is frequently asymptomatic but can sometimes lead to symptomatic tumour-like masses. No guidelines or common consensus are available in literature regarding the different treatment strategies and only single c...

    journal_title:Internal medicine journal

    pub_type: 杂志文章,评审

    doi:10.1111/imj.12386

    authors: Ruo Redda MG,Allis S,Reali A,Bartoncini S,Roggero S,Anglesio SM,Piga A

    更新日期:2014-04-01 00:00:00

  • Cardiovascular risk reduction in hypertension: angiotensin-converting enzyme inhibitors, angiotensin receptor blockers. Where are we up to?

    abstract::Previously, management of hypertension has concentrated on lowering elevated blood pressure. However, the target has shifted to reducing absolute cardiovascular (CV) risk. It is estimated that two in three Australian adults have three or more CV risk factors at the same time. Moderate reductions in several risk factor...

    journal_title:Internal medicine journal

    pub_type: 杂志文章,评审

    doi:10.1111/imj.12975

    authors: Sindone A,Erlich J,Lee C,Newman H,Suranyi M,Roger SD

    更新日期:2016-03-01 00:00:00

  • Using simulation models to teach junior doctors how to insert chest tubes: a brief and effective teaching module.

    abstract:BACKGROUND:Pleural procedures may cause serious complications when incorrectly carried out. There is a need to find effective methods for teaching how to insert a chest drain safely. AIM:To assess the effectiveness of a programme for teaching chest tube insertion using a simulation model (SuperAnnie). METHODS:Groups ...

    journal_title:Internal medicine journal

    pub_type: 杂志文章

    doi:10.1111/j.1445-5994.2007.01586.x

    authors: Hutton IA,Kenealy H,Wong C

    更新日期:2008-12-01 00:00:00

  • Changing prevalence of aetiological factors and comorbidities among Australians hospitalised for cirrhosis.

    abstract:BACKGROUND:The rate of hospital admissions for cirrhosis increased 1.3-fold during 2008-2016 in Queensland. Alcohol misuse was a contributing factor for cirrhosis in 55% of admissions and 40% of patients had at least one comorbidity. AIM:This paper examines the temporal change in aetiology of liver disease and presenc...

    journal_title:Internal medicine journal

    pub_type: 杂志文章

    doi:10.1111/imj.14809

    authors: Valery PC,McPhail S,Stuart KA,Hartel G,Clark PJ,O'Beirne J,Skoien R,Rahman T,Moser C,Powell EE

    更新日期:2020-02-25 00:00:00

  • Clinical outcomes in patients with advanced epidermal growth factor receptor-mutated non-small-cell lung cancer in South Western Sydney Local Health District.

    abstract:BACKGROUND:Epidermal growth factor receptor (EGFR)-mutated non-small-cell lung cancer (NSCLC) is a subgroup of oncogene addicted lung cancer that predicts response to tyrosine kinase inhibitors (TKI). However, there is variability in response and survival outcomes in patients with EGFR mutation treated with TKI. AIM:T...

    journal_title:Internal medicine journal

    pub_type: 杂志文章

    doi:10.1111/imj.13555

    authors: Ding PN,Roberts TL,Chua W,Becker TM,Descallar J,Yip PY,Bray V

    更新日期:2017-12-01 00:00:00

  • Rhabdomyolysis in association with simvastatin and dosage increment in clarithromycin.

    abstract::Clarithromycin is the most documented cytochrome P450 3A4 (CYP3A4) inhibitor to cause an adverse interaction with simvastatin. This particular case is of interest as rhabdomyolysis only occurred after an increase in the dose of clarithromycin. The patient developed raised cardiac biomarkers without any obvious cardiac...

    journal_title:Internal medicine journal

    pub_type: 杂志文章

    doi:10.1111/imj.12464

    authors: Page SR,Yee KC

    更新日期:2014-07-01 00:00:00

  • Death, dependency and health status 90 days following hospital admission for acute stroke in NSW.

    abstract:BACKGROUND:Stroke is an Australian health priority area causing considerable levels of disability. We report 90-day outcomes for a cohort of acute stroke patients in New South Wales (NSW), Australia prior to randomization to a large cluster randomized controlled trial (CRCT), the Quality in Acute Stroke Care (QASC) tri...

    journal_title:Internal medicine journal

    pub_type: 杂志文章

    doi:10.1111/j.1445-5994.2010.02330.x

    authors: Middleton S,Levi C,Ward J,Grimshaw J,Griffiths R,D'Este C,Dale S,Quinn C,Evans M,Cadilhac D,McElduff P

    更新日期:2011-10-01 00:00:00

  • Antifungal prophylaxis in adult stem cell transplantation and haematological malignancy.

    abstract::Antifungal prophylaxis can be recommended in patients undergoing induction chemotherapy for acute myeloid leukemia and treatment for grade 2 or greater or chronic extensive graft versus host disease. The evidence for prophylaxis is less clear in other clinical settings although certain groups such as patients with pro...

    journal_title:Internal medicine journal

    pub_type: 杂志文章,实务指引

    doi:10.1111/j.1445-5994.2008.01723.x

    authors: Slavin MA,Heath CH,Thursky KA,Morrissey CO,Szer J,Ling LM,Milliken ST,Grigg AP

    更新日期:2008-06-01 00:00:00

  • Hypomagnesaemia linked to depression: a systematic review and meta-analysis.

    abstract:BACKGROUND:The reported risk of depression in patients with hypomagnesaemia is controversial. AIM:The objective of this meta-analysis was to assess the association between depression and hypomagnesaemia. METHODS:A literature search was performed using MEDLINE, EMBASE, Cochrane Database and clinicaltrials.gov from inc...

    journal_title:Internal medicine journal

    pub_type: 杂志文章,meta分析,评审

    doi:10.1111/imj.12682

    authors: Cheungpasitporn W,Thongprayoon C,Mao MA,Srivali N,Ungprasert P,Varothai N,Sanguankeo A,Kittanamongkolchai W,Erickson SB

    更新日期:2015-04-01 00:00:00

  • Global climate change: time to mainstream health risks and their prevention on the medical research and policy agenda.

    abstract::Climate change is unequivocal. The fourth assessment report of the Intergovermental Panel on Climate Change has recently projected that global average surface temperature will increase by 1.1 to 6.4 degrees C by 2100. Anthropogenic warming during the twenty-first century would be much greater than that observed in the...

    journal_title:Internal medicine journal

    pub_type: 杂志文章,评审

    doi:10.1111/j.1445-5994.2008.01688.x

    authors: Tong S,Mackenzie J,Pitman AJ,FitzGerald G,Nicholls N,Selvey L

    更新日期:2008-06-01 00:00:00

  • Counting the costs of treatment: the reproductive and gynaecological consequences of adjuvant therapy in young women with breast cancer.

    abstract::As the mortality rate from breast cancer decreases, the issues facing breast cancer survivors are becoming increasingly important. Survivors of all ages may face physical and psychosocial consequences of their diagnosis and treatments. However, the long-term fertility and menopause-related side-effects of adjuvant the...

    journal_title:Internal medicine journal

    pub_type: 杂志文章,评审

    doi:10.1046/j.1445-5994.2003.00377.x

    authors: Friedlander M,Thewes B

    更新日期:2003-08-01 00:00:00

  • Detection of bacteria and analyses of Chlamydia trachomatis viability in patients with postvenereal reactive arthritis.

    abstract::Postvenereal reactive arthritis is an inflammatory form of arthritis that commonly develops after urogenital infection, predominantly in human leucocyte antigen-B27-positive men in the third decade of life. In our hospital, patients underwent synovectomy before a 4-month course of antibiotics (ciprofloxacin, tetracycl...

    journal_title:Internal medicine journal

    pub_type: 杂志文章

    doi:10.1111/imj.12580

    authors: Strelić N,Bojović J,Pavlica L,Cikota-Aleksić B,Miličić B,Magić Z

    更新日期:2014-12-01 00:00:00

  • Conditions associated with extreme hyperferritinaemia (>3000 μg/L) in adults.

    abstract:BACKGROUND:The clinical significance of extreme hyperferritinaemia has come under scrutiny with the increasing recognition of haemophagocytic lymphohistiocytosis (HLH) in adults. Most studies of hyperferritinaemia have focused on serum ferritin greater than 1000 μg/L, often in ambulatory patients. The conditions associ...

    journal_title:Internal medicine journal

    pub_type: 杂志文章

    doi:10.1111/imj.12768

    authors: Wormsbecker AJ,Sweet DD,Mann SL,Wang SY,Pudek MR,Chen LY

    更新日期:2015-08-01 00:00:00

  • Adherence and outcomes of patients prescribed dabigatran (Pradaxa) in routine clinical practice.

    abstract:AIM:To explore and detail clinical experiences of dabigatran, a novel anticoagulant, after it became available in New Zealand in July 2011. METHODS:A cohort of patients was recruited from Hutt Hospital and the two largest primary care practices in the Hutt Valley region. They were included if they took at least one do...

    journal_title:Internal medicine journal

    pub_type: 杂志文章,多中心研究,随机对照试验

    doi:10.1111/imj.12370

    authors: Thorne K,Jayathissa S,Dee S,Briggs N,Taylor J,Reid S,De Silva K,Dean J

    更新日期:2014-03-01 00:00:00

  • Are Australasian academic physicians an endangered species?

    abstract::It has been stated that academic medicine is in a worldwide crisis. Is this decline in hospital academic practice a predictable consequence of modern clinical practice with its emphasis on community and outpatient-based services as well as a corporate health-care ethos or does it relate to innate problems in the train...

    journal_title:Internal medicine journal

    pub_type: 杂志文章,评审

    doi:10.1111/j.1445-5994.2007.01490.x

    authors: Wilson A

    更新日期:2007-11-01 00:00:00

  • Trends in practice: attitudes and challenges in the diagnosis, treatment and management of HIV infection in Australia.

    abstract::As life expectancy for people living with human immunodeficiency virus (HIV) (PLWHIV) increases, management models for HIV infection are changing. To understand approaches to practice within this shifting climate and across different medical settings, in 2017 we conducted a baseline survey among the main medical pract...

    journal_title:Internal medicine journal

    pub_type: 杂志文章

    doi:10.1111/imj.15129

    authors: Smith DE,Woolley IJ,Russell DB,Bisshop F,Furner V

    更新日期:2020-12-01 00:00:00

  • Focus on systemic lupus erythematosus in indigenous Australians: towards a better understanding of autoimmune diseases.

    abstract::The incidence and prevalence of autoimmune diseases such as rheumatoid arthritis, primary Sjögren syndrome, scleroderma and systemic lupus erythematosus (SLE) varies with geography and ethnicity. For example, SLE is reported to be more common in populations such as African-Caribbeans and Indigenous Australians (IA). A...

    journal_title:Internal medicine journal

    pub_type: 杂志文章,评审

    doi:10.1111/imj.12039

    authors: Vincent FB,Bourke P,Morand EF,Mackay F,Bossingham D

    更新日期:2013-03-01 00:00:00

  • Readmission and survival following hospitalization for chronic obstructive pulmonary disease: long-term trends.

    abstract:BACKGROUND:Exacerbations requiring hospital admission for chronic obstructive pulmonary disease (COPD) contribute to a decline in health status and are costly to the community. Long-term trends in admissions and associated outcomes are difficult to establish because of frequent readmissions, high case fatality and pote...

    journal_title:Internal medicine journal

    pub_type: 杂志文章

    doi:10.1111/j.1445-5994.2007.01240.x

    authors: Geelhoed EA,Brameld KJ,Holman CD,Thompson PJ

    更新日期:2007-02-01 00:00:00

  • Creatinine as predictor value of mortality and acute kidney injury in rhabdomyolysis.

    abstract:BACKGROUND:Rhabdomyolysis (RB) is a syndrome characterised by decomposition of skeletal muscle that could be life threatening, so the identification of biomarkers of its severity could help us in its treatment. Creatine kinase (CK) is usually taken as a reference in patients with RB in order to stratify prognosis, howe...

    journal_title:Internal medicine journal

    pub_type: 杂志文章

    doi:10.1111/imj.12815

    authors: Baeza-Trinidad R,Brea-Hernando A,Morera-Rodriguez S,Brito-Diaz Y,Sanchez-Hernandez S,El Bikri L,Ramalle-Gomara E,Garcia-Alvarez JL

    更新日期:2015-11-01 00:00:00

  • Role of venous blood gases in hypercapnic respiratory failure chronic obstructive pulmonary disease patients presenting to the emergency department.

    abstract:BACKGROUND:Many patients with acute exacerbations of chronic obstructive pulmonary disease (AECOPD) have type 2 respiratory failure (T2RF). Often arterial blood gases are not performed and correlation with venous blood gases (VBG) is controversial. The venous pH and bicarbonate (HCO3 ) are useful, but VBG pCO2 (PvCO2 )...

    journal_title:Internal medicine journal

    pub_type: 杂志文章

    doi:10.1111/imj.14186

    authors: Wong EKC,Lee PCS,Ansary S,Asha S,Wong KKH,Yee BJ,Ng AT

    更新日期:2019-07-01 00:00:00

  • Implementing practice change in chronic cancer pain management: clinician response to a phase III study of ketamine.

    abstract:BACKGROUND:An adequately powered, double-blind, multisite, randomised controlled trial has shown no net clinical benefit for subcutaneous ketamine over placebo in the management of cancer pain refractory to combination opioid and co-analgesic therapy. The results of the trial were disseminated widely both nationally an...

    journal_title:Internal medicine journal

    pub_type: 杂志文章

    doi:10.1111/imj.12442

    authors: Hardy JR,Spruyt O,Quinn SJ,Devilee LR,Currow DC

    更新日期:2014-06-01 00:00:00

  • Patients with multiple myeloma over a large catchment of 2.5 million square kilometres: a Western Australia retrospective survival review.

    abstract::Multiple myeloma is an incurable malignancy of plasma cells. We retrospectively reviewed the survival outcomes of patients with multiple myeloma in Western Australia (WA) public hospitals over a 10-year period. We did not detect a difference in survival between patients residing the metropolitan Perth and regional are...

    journal_title:Internal medicine journal

    pub_type: 杂志文章

    doi:10.1111/imj.14905

    authors: Ng TF,Burrow S,Leahy M,Augustson B,Trentino K,De Kraa R,Wright M,Carnley B

    更新日期:2020-07-01 00:00:00

  • Permanent peritoneal ports for the management of recurrent malignant ascites: a retrospective review of safety and efficacy.

    abstract::Large volume paracentesis is effective in relieving the symptoms of malignant ascites, but frequent procedures are often required. Permanent peritoneal ports are an alternative to repeated procedures. We describe our experience with the use of peritoneal ports in patients at Middlemore Hospital (Auckland, New Zealand)...

    journal_title:Internal medicine journal

    pub_type: 杂志文章

    doi:10.1111/imj.14137

    authors: Chen BS,Wong SHC,Hawkins S,Huggins L

    更新日期:2018-12-01 00:00:00

  • Spectrum of illness among returned Australian travellers from Bali, Indonesia: a 5-year retrospective observational study.

    abstract:BACKGROUND:Bali, Indonesia, presents significant infectious and non-infectious health risks for Australian travellers. Understanding this spectrum of illnesses has the potential to assist clinicians in evaluating unwell returning travellers and guide provision of pre-travel advice. AIM:To describe the spectrum of illn...

    journal_title:Internal medicine journal

    pub_type: 杂志文章

    doi:10.1111/imj.13993

    authors: Sohail A,McGuinness SL,Lightowler R,Leder K,Jomon B,Bain CA,Peleg AY

    更新日期:2019-01-01 00:00:00