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Table 3 Crude and adjusted hazard ratios of in-hospital death or a composite of death and ICU admission, according to the discontinuation or continuation of in-hospital of ACEIs and ARBs, either pooling as a group (RASIs) or disaggregated. The category of reference is the continuation of RASIs, ARBs, and ACEIs, respectively

From: Impact of in-hospital discontinuation with angiotensin receptor blockers or converting enzyme inhibitors on mortality of COVID-19 patients: a retrospective cohort study

Outcome

RASIs discontinued#

N=340

RASIs continued##

N=285

Crude HR (95%CI)

PS-adj HR* (95%CI)

MC- HR**

(95%CI)

Patients with event

Event rate (%)

Patients with event

Event rate (%)

Death

94

27.6

79

27.7

0.94 (0.70–1.27)

1.01 (0.71–1.46)

1.01 (0.70–1.46)

Death + ICU

107

31.5

89

31.2

0.95 (0.71–1.25)

1.02 (0.73–1.44)

1.05 (0.75–1.48)

Outcome

ARBs discontinued

N=168

ARBs continued

N=125

Crude HR (95%CI)

PS-adj HR* (95%CI)

MC-HR**

(95%CI)

Patients with event

Event rate (%)

Patients with event

Event rate (%)

Death

48

28.6

26

20.8

1.35 (0.84–2.17)

1.58 (0.87–2.87)

1.59 (0.89–2.85)

Death + ICU

54

32.1

32

25.6

1.19 (0.77–1.85)

1.23 (0.71–2.14)

1.27 (0.72–2.22)

Outcome

ACEIs discontinued

N=170

ACEIs continued

N=136

Crude HR (95%CI)

PS-adj HR* (95%CI)

MC-HR**

(95%CI)

Patients with event

Event rate (%)

Patients with event

Event rate (%)

Death

46

27.1

45

33.1

0.77 (0.51–1.15)

0.73 (0.44–1.19)

0.70 (0.42–1.17)

Death + ICU

53

31.2

48

35.3

0.84 (0.57–1.24)

0.83 (0.52–1.34)

0.85 (0.53–1.37)

  1. Abbreviations: ACEIs angiotensin-converting enzyme inhibitors, ARBs angiotensin receptor blockers, CI confidence interval, HR hazard ratio, ICU intensive care unit, RASIs renin-angiotensin system inhibitors
  2. #2 patients discontinued a dual ACEI-ARB treatment and were excluded from the disaggregated analysis below
  3. ##9 patients who were prior users of ARBs continued with ACEIs in-hospital, 8 patients who were prior users of ACEIs continued in hospital with ARBs, and 7 patients received dual ACEI-ARB treatment. All of them (n=24) were excluded from the disaggregated analysis below by ACEIs and ARBs
  4. *Propensity-scores-adjusted hazard ratio (adjusted total effect)
  5. **Mediator-controlled hazard ratio (controlled direct effect): (a) systemic corticosteroids, anticoagulants, and immunomodulators when the outcome was death and (b) immunomodulators and anticoagulants when the outcome was death plus ICU admission
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BMC Medicine

ISSN: 1741-7015

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