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Renin-angiotensin-aldosterone system blockers are not associated with coronavirus disease 2019 (COVID-19) hospitalisation: study of 1439 UK biobank cases

Renin-angiotensin-aldosterone system blockers are not associated with coronavirus disease 2019 (COVID-19) hospitalisation: study of 1439 UK biobank cases
Renin-angiotensin-aldosterone system blockers are not associated with coronavirus disease 2019 (COVID-19) hospitalisation: study of 1439 UK biobank cases
Background: Cardiometabolic morbidity and medications, specifically Angiotensin Converting Enzyme inhibitors (ACEi) and Angiotensin Receptor Blockers (ARBs), have been linked with adverse outcomes from coronavirus disease 2019 (COVID-19). This study aims to investigate, factors associated with COVID-19 positivity in hospital for 1,436 UK Biobank participants; compared with individuals who tested negative, and with the untested, presumed negative, rest of the cohort.

Methods: We studied 7,099 participants from the UK Biobank who had been tested for COVID-19 in hospital. We considered the following exposures: age, sex, ethnicity, body mass index (BMI), diabetes, hypertension, hypercholesterolaemia, ACEi/ARB use, prior myocardial infarction (MI), and smoking. We undertook comparisons between 1) COVID-19 positive and COVID-19 negative tested participants; and 2) COVID-19 tested positive and the remaining participants (tested negative plus untested, n=494,838). Logistic regression models were used to investigate univariate and mutually adjusted associations.

Results: Among participants tested for COVID-19, Black, Asian, and Minority ethnic (BAME) ethnicity, male sex, and higher BMI were independently associated with a positive result. BAME ethnicity, male sex, greater BMI, diabetes, hypertension, and smoking were independently associated with COVID-19 positivity compared to the remining cohort (test negatives plus untested). However, similar associations were observed when comparing those who tested negative for COVID-19 with the untested cohort; suggesting that these factors associate with general hospitalisation rather than specifically with COVID-19.

Conclusions: Among participants tested for COVID-19 with presumed moderate to severe symptoms in a hospital setting, BAME ethnicity, male sex, and higher BMI are associated with a positive result. Other cardiometabolic morbidities confer increased risk of hospitalisation, without specificity for COVID-19. ACE/ARB use did not associate with COVID-19 status.
Raisi-Estabragh, Zahra
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McCracken, Celeste
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Ardissino, Maddalena
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Bethell, Mae S.
c3af4794-abd4-47d6-bf1c-c0ee84741184
Cooper, Jackie
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Cooper, Cyrus
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Harvey, Nicholas
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Petersen, Steffen E.
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Raisi-Estabragh, Zahra
43c85c5e-4574-476b-80d6-8fb1cdb3df0a
McCracken, Celeste
5d772e9e-3aaa-41da-a5ef-3943b1631fd9
Ardissino, Maddalena
2cfd4d91-f405-4ed0-912b-313b0316c0fb
Bethell, Mae S.
c3af4794-abd4-47d6-bf1c-c0ee84741184
Cooper, Jackie
f78de577-4cac-496f-ad11-5f59dd305046
Cooper, Cyrus
e05f5612-b493-4273-9b71-9e0ce32bdad6
Harvey, Nicholas
ce487fb4-d360-4aac-9d17-9466d6cba145
Petersen, Steffen E.
04f2ce88-790d-48dc-baac-cbe0946dd928

Raisi-Estabragh, Zahra, McCracken, Celeste, Ardissino, Maddalena, Bethell, Mae S., Cooper, Jackie, Cooper, Cyrus, Harvey, Nicholas and Petersen, Steffen E. (2020) Renin-angiotensin-aldosterone system blockers are not associated with coronavirus disease 2019 (COVID-19) hospitalisation: study of 1439 UK biobank cases. Frontiers in Cardiovascular Medicine. (In Press)

Record type: Article

Abstract

Background: Cardiometabolic morbidity and medications, specifically Angiotensin Converting Enzyme inhibitors (ACEi) and Angiotensin Receptor Blockers (ARBs), have been linked with adverse outcomes from coronavirus disease 2019 (COVID-19). This study aims to investigate, factors associated with COVID-19 positivity in hospital for 1,436 UK Biobank participants; compared with individuals who tested negative, and with the untested, presumed negative, rest of the cohort.

Methods: We studied 7,099 participants from the UK Biobank who had been tested for COVID-19 in hospital. We considered the following exposures: age, sex, ethnicity, body mass index (BMI), diabetes, hypertension, hypercholesterolaemia, ACEi/ARB use, prior myocardial infarction (MI), and smoking. We undertook comparisons between 1) COVID-19 positive and COVID-19 negative tested participants; and 2) COVID-19 tested positive and the remaining participants (tested negative plus untested, n=494,838). Logistic regression models were used to investigate univariate and mutually adjusted associations.

Results: Among participants tested for COVID-19, Black, Asian, and Minority ethnic (BAME) ethnicity, male sex, and higher BMI were independently associated with a positive result. BAME ethnicity, male sex, greater BMI, diabetes, hypertension, and smoking were independently associated with COVID-19 positivity compared to the remining cohort (test negatives plus untested). However, similar associations were observed when comparing those who tested negative for COVID-19 with the untested cohort; suggesting that these factors associate with general hospitalisation rather than specifically with COVID-19.

Conclusions: Among participants tested for COVID-19 with presumed moderate to severe symptoms in a hospital setting, BAME ethnicity, male sex, and higher BMI are associated with a positive result. Other cardiometabolic morbidities confer increased risk of hospitalisation, without specificity for COVID-19. ACE/ARB use did not associate with COVID-19 status.

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Accepted/In Press date: 30 June 2020
Additional Information: To be published by Frontiers Media

Identifiers

Local EPrints ID: 441959
URI: http://eprints.soton.ac.uk/id/eprint/441959
PURE UUID: 7c2cf48a-3fdd-4177-ae29-741ff99bbc4a
ORCID for Cyrus Cooper: ORCID iD orcid.org/0000-0003-3510-0709
ORCID for Nicholas Harvey: ORCID iD orcid.org/0000-0002-8194-2512

Catalogue record

Date deposited: 03 Jul 2020 16:30
Last modified: 18 Feb 2021 17:02

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Contributors

Author: Zahra Raisi-Estabragh
Author: Celeste McCracken
Author: Maddalena Ardissino
Author: Mae S. Bethell
Author: Jackie Cooper
Author: Cyrus Cooper ORCID iD
Author: Nicholas Harvey ORCID iD
Author: Steffen E. Petersen

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