Korean J Intern Med.  2021 Mar;36(Suppl 1):S114-S122. 10.3904/kjim.2020.380.

Update on association between exposure to renin-angiotensin-aldosterone system inhibitors and coronavirus disease 2019 in South Korea

• Seo J
• Son M

• KMID: 2513819
• DOI: http://doi.org/10.3904/kjim.2020.380

Abstract

Background/Aims
Since the onset of the coronavirus disease 2019 (COVID-19) pandemic, there have been concerns about the association between exposure to renin-angiotensin-aldosterone system (RAAS) inhibitors and the risk and severity of COVID-19.
Methods
We performed a case-control study that utilized up-to-date data on the South Korean population provided by the Korean National Health Insurance System. Of the 62,909 patients with hypertension or heart failure tested for COVID-19, there were 1,644 (2.6%) confirmed cases. After case-control matching, multivariable-adjusted conditional logistic regression analysis was performed.
Results
Comparison between patients exposed to RAAS inhibitors and those not exposed to RAAS inhibitors revealed that the adjusted odds ratio (OR) and 95% confidence interval (CI) for COVID-19 infection and death were 0.981 (95% CI, 0.849 to 1.135) and 0.875 (95% CI, 0.548 to 1.396), respectively. Subgroup analysis for the major confounders, age and region of diagnosis, resulted in OR of 0.912 (95% CI, 0.751 to 1.108) and 0.942 (95% CI, 0.791 to 1.121), respectively.
Conclusions
The present study demonstrated no evidence of association between RAAS inhibitor exposure and risk and severity of COVID-19.

Keyword

Renin-angiotensin system; COVID-19; Hypertension; Heart failure; Republic of Korea