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Article

Impact of Chronic RAAS Use in Elderly COVID-19 Patients: A Retrospective Analysis

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Department of Nephrology and Renal Transplantation, Centro Hospitalar Universitário Lisboa Norte, 1649-028 Lisboa, Portugal
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Department of Internal Medicine, Centro Hospitalar Universitário Lisboa Norte, 1649-028 Lisboa, Portugal
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Author to whom correspondence should be addressed.
Academic Editor: Andrea Dell’Amore
J. Clin. Med. 2021, 10(14), 3147; https://doi.org/10.3390/jcm10143147
Received: 5 June 2021 / Revised: 11 July 2021 / Accepted: 14 July 2021 / Published: 16 July 2021
(This article belongs to the Section Cardiovascular Medicine)
Corona Virus Disease-19 (COVID-19) recently emerged as a global pandemic. Advanced age is the most important risk factor for increased virus susceptibility and worse outcomes. Many older adults are currently treated with renin–angiotensin–aldosterone system (RAAS) inhibitors and there is concern that these medications might increase the risk of mortality by COVID-19. This is a retrospective cohort of 346 patients older than 65 years with COVID-19, at the Department of Medicine of the Centro Hospitalar Universitário Lisboa Norte, in Portugal, hospitalized between March 2020 and August 2020. Mean age was 80.9 ± 8.7 years old. Most patients had arterial hypertension (n = 279, 80.6%), almost half (n = 161, 46.5%) had cardiovascular disease and approximately one-third of patients had heart failure (n = 127, 36.7%) or diabetes Mellitus (n = 113, 32.7%). Ninety-eight patients (28.3%) had chronic kidney disease and almost half of the patients (49.4%) were chronically under renin–angiotensin–aldosterone system (RAAS) inhibitors. Twenty percent of patients died during hospitalization. In a multivariate analysis, older age (OR 1.11, 95% CI 1.04, 1.18, p = 0.002), absence of baseline medication with RAAS inhibitors (OR 0.27, 95% CI 0.10, 0.75, p = 0.011), higher serum ferritin (OR 1.00, 95% CI 1.00, 1.00, p = 0.003) and higher lactate levels (OR 1.08, 95% CI 1.02, 1.14, p = 0.006) were independent predictors of mortality. Older age, higher serum ferritin and lactate levels at admission were found to be independent predictors of mortality and might act as early predictors of worsening disease in clinical practice. Chronic treatment with RAAS inhibitors appeared to be protective, supporting guidelines in not discontinuing such drugs. View Full-Text
Keywords: elderly; COVID-19; renin–angiotensin–aldosterone system; mortality elderly; COVID-19; renin–angiotensin–aldosterone system; mortality
MDPI and ACS Style

Oliveira, J.; Gameiro, J.; Bernardo, J.; Marques, F.; Costa, C.; Branco, C.; Duarte, I.; Fonseca, J.; Carreiro, C.; Braz, S.; Lopes, J.A. Impact of Chronic RAAS Use in Elderly COVID-19 Patients: A Retrospective Analysis. J. Clin. Med. 2021, 10, 3147. https://doi.org/10.3390/jcm10143147

AMA Style

Oliveira J, Gameiro J, Bernardo J, Marques F, Costa C, Branco C, Duarte I, Fonseca J, Carreiro C, Braz S, Lopes JA. Impact of Chronic RAAS Use in Elderly COVID-19 Patients: A Retrospective Analysis. Journal of Clinical Medicine. 2021; 10(14):3147. https://doi.org/10.3390/jcm10143147

Chicago/Turabian Style

Oliveira, João, Joana Gameiro, João Bernardo, Filipe Marques, Cláudia Costa, Carolina Branco, Inês Duarte, José Fonseca, Carolina Carreiro, Sandra Braz, and José A. Lopes 2021. "Impact of Chronic RAAS Use in Elderly COVID-19 Patients: A Retrospective Analysis" Journal of Clinical Medicine 10, no. 14: 3147. https://doi.org/10.3390/jcm10143147

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