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Use of drugs for hypertension or heart failure and the risk of death in COVID-19: association with loop-diuretics.
Fastbom, Johan; Jonasdottir Bergman, Gudrun; Holm, Johanna; Hanberger, Håkan; Strålin, Kristoffer; Walther, Sten; Alfredsson, Joakim; State, Maria; Borg, Natalia; Nyman Iliadou, Anastasia.
Afiliación
  • Fastbom J; National Board of Health and Welfare (Socialstyrelsen), Stockholm, Sweden. johan.fastbom@socialstyrelsen.se.
  • Jonasdottir Bergman G; Aging Research Center, Karolinska Institutet and Stockholm University, Stockholm, Sweden. johan.fastbom@socialstyrelsen.se.
  • Holm J; National Board of Health and Welfare (Socialstyrelsen), Stockholm, Sweden.
  • Hanberger H; National Board of Health and Welfare (Socialstyrelsen), Stockholm, Sweden.
  • Strålin K; Department of Clinical and Experimental Medicine, Infectious Diseases, Faculty of Health Sciences, Linköping University, Linköping, Sweden.
  • Walther S; Department of Infectious Diseases, Karolinska University Hospital, Stockholm, Sweden.
  • Alfredsson J; Department of Cardiothoracic and Vascular Surgery. Heart Centre, Linköping University Hospital and Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden.
  • State M; Department of Health Medicine and Caring Sciences and Department of Cardiology, Linköping University, Linköping, Sweden.
  • Borg N; National Board of Health and Welfare (Socialstyrelsen), Stockholm, Sweden.
  • Nyman Iliadou A; National Board of Health and Welfare (Socialstyrelsen), Stockholm, Sweden.
Eur J Clin Pharmacol ; 80(10): 1515-1522, 2024 Oct.
Article en En | MEDLINE | ID: mdl-38913169
ABSTRACT

PURPOSE:

To study the association between the use of drugs for hypertension or heart failure, particularly diuretics, and risk of death in COVID-19.

METHODS:

We conducted a cohort study, based on record linked individual-based data from national registers, of all Swedish inhabitants 50 years and older (n = 3,909,321) at the start of the first SARS-CoV-2 wave in Sweden. The association between use of angiotensin-converting enzyme inhibitors (ACEI), angiotensin II receptor blockers (ARB), thiazides, loop diuretics, aldosterone antagonists, beta blocking agents and calcium channel blockers at the index date 6 March 2020, and death in COVID-19 during 7 March to 31 July 2020, was analysed using Cox-proportional hazards regression, adjusted for a wide range of possible confounders.

RESULTS:

Use of loop diuretics was associated with higher risk [adjusted hazard ratio (HR) 1.26; 95% confidence interval (95% CI) 1.17-1.35] and thiazides with reduced risk (0.78; 0.69-0.88) of death in COVID-19. In addition, lower risk was observed for ACEI and higher risk for beta-blocking agents, although both associations were weak. For ARB, aldosterone antagonists and calcium channel blockers no significant associations were found.

CONCLUSION:

In this nationwide cohort of nearly 4 million persons 50 years and older, the use of loop diuretics was associated with increased risk of death in COVID-19 during the first SARS-CoV-2 wave in Sweden. This contrasted to the decreased risk observed for thiazides. As treatment with loop diuretics is common, particularly in the elderly, the group most affected by severe COVID-19, this finding merit further investigation.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: COVID-19 / Insuficiencia Cardíaca / Hipertensión Límite: Aged / Aged80 / Female / Humans / Male / Middle aged País/Región como asunto: Europa Idioma: En Revista: Eur J Clin Pharmacol Año: 2024 Tipo del documento: Article País de afiliación: Suecia Pais de publicación: Alemania
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: COVID-19 / Insuficiencia Cardíaca / Hipertensión Límite: Aged / Aged80 / Female / Humans / Male / Middle aged País/Región como asunto: Europa Idioma: En Revista: Eur J Clin Pharmacol Año: 2024 Tipo del documento: Article País de afiliación: Suecia Pais de publicación: Alemania