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Volume 13
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10.3390/healthcare13111270
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This is an early access version, the complete PDF, HTML, and XML versions will be available soon.
Article

COVID-19 Pandemic Waves and 2024–2025 Winter Season in Relation to Angiotensin-Converting Enzyme Inhibitors, Angiotensin Receptor Blockers and Amantadine

by
Anna Puigdellívol-Sánchez
1,2,*,
Marta Juanes-González
1,
Ana Isabel Calderón-Valdiviezo
1,
Helena Losa-Puig
1,3,
Marta González-Salvador
4,
Marc León-Pérez
1,5,
Luís Pueyo-Antón
1,
Maite Franco-Romero
1,6,
Celia Lozano-Paz
1,
Albert Cortés-Borra
7 and
Roger Valls-Foix
1
1
Medicina de Familia, CAP Anton de Borja-Centre Universitari, c/Marconi-Cantonada Edison s/n, Consorci Sanitari de Terrassa (CST), 08191 Rubí, Spain
2
Human Anatomy and Embryology Unit, Faculty of Medicine, c/Casanova 143, Universitat de Barcelona, 08036 Barcelona, Spain
3
Hospital Álvaro Cunqueiro, Estrada de Clara Campoamor 341, 36213 Vigo, Spain
4
Management, Control and Information Analysis Unit, Hospital de Terrassa, Consorci Sanitari de Terrassa (CST), Carretera de Torrebonica s/n, 08227 Terrassa, Spain
5
Independent Researcher, 08207 Sabadell, Spain
6
Parc Sanitari Pere Virgili, c/d’Esteve Terradas, 30, Gràcia, 08023 Barcelona, Spain
7
CAP La Garriga, c/Torrent de la Sínia 7, Institut Català de la Salut, 08530 La Garriga, Spain
*
Author to whom correspondence should be addressed.
Healthcare 2025, 13(11), 1270; https://doi.org/10.3390/healthcare13111270
Submission received: 31 March 2025 / Revised: 20 May 2025 / Accepted: 26 May 2025 / Published: 27 May 2025
(This article belongs to the Section Community Care)
Versions Notes

Abstract

Background: Early pandemic reports suggested improved outcomes in hypertensive COVID-19 patients treated with angiotensin-converting enzyme inhibitors (ACEI) or amantadine. This study evaluates their impact on disease progression. Methods: We analyzed 55,936 infected patients (March 2020–January 2025) and 2024 hospital admissions within a free-access Barcelona metropolitan health consortium (n = 192,651 as of March 2025). Hospitalizations, stratified by polypharmacy level (nT), were compared via Chi-square tests. ICU admissions and length of stay in hospitalized patients were assessed during the first month of key waves: initial A2a + B3a + B9 (n = 184, March 2020), Delta (n = 158, July 2021), Omicron21K (n = 142, January 2022), and Omicron 24F (n = 8, January 2025). Results: Non-survivors were predominantly aged >60 years (96.3%) in the first wave and >70 years (100%) in Delta/Omicron waves. Post-vaccination, mortality decreased in high-comorbidity groups, though hospitalizations/ICU admissions in younger patients surpassed first-wave levels during Delta. Vaccinated ACEI/ARB-treated patients showed reduced hospitalizations across all polypharmacy groups: OR (noACEI/ACEI) = 1.21 (≥2 nT) to 4.26 (1 nT, p = 0.014); OR (noARB/ARB) = 1.24 (≥8 nT) to 1.74 (2–7 nT, p = 0.01). No hospitalizations occurred in amantadine-treated patients aged <70. Conclusions: These findings suggest a potential protective effect of ACEI, ARBs, and amantadine against severe COVID-19 and support the safety and continuity of these treatments. Multicentric studies incorporating post-COVID syndrome data are needed to validate these observations if hospitalizations persist.
Keywords: COVID-19; ACE inhibitors; angiotensin receptor blockers; amantadine COVID-19; ACE inhibitors; angiotensin receptor blockers; amantadine

Share and Cite

MDPI and ACS Style

Puigdellívol-Sánchez, A.; Juanes-González, M.; Calderón-Valdiviezo, A.I.; Losa-Puig, H.; González-Salvador, M.; León-Pérez, M.; Pueyo-Antón, L.; Franco-Romero, M.; Lozano-Paz, C.; Cortés-Borra, A.; et al. COVID-19 Pandemic Waves and 2024–2025 Winter Season in Relation to Angiotensin-Converting Enzyme Inhibitors, Angiotensin Receptor Blockers and Amantadine. Healthcare 2025, 13, 1270. https://doi.org/10.3390/healthcare13111270

AMA Style

Puigdellívol-Sánchez A, Juanes-González M, Calderón-Valdiviezo AI, Losa-Puig H, González-Salvador M, León-Pérez M, Pueyo-Antón L, Franco-Romero M, Lozano-Paz C, Cortés-Borra A, et al. COVID-19 Pandemic Waves and 2024–2025 Winter Season in Relation to Angiotensin-Converting Enzyme Inhibitors, Angiotensin Receptor Blockers and Amantadine. Healthcare. 2025; 13(11):1270. https://doi.org/10.3390/healthcare13111270

Chicago/Turabian Style

Puigdellívol-Sánchez, Anna, Marta Juanes-González, Ana Isabel Calderón-Valdiviezo, Helena Losa-Puig, Marta González-Salvador, Marc León-Pérez, Luís Pueyo-Antón, Maite Franco-Romero, Celia Lozano-Paz, Albert Cortés-Borra, and et al. 2025. "COVID-19 Pandemic Waves and 2024–2025 Winter Season in Relation to Angiotensin-Converting Enzyme Inhibitors, Angiotensin Receptor Blockers and Amantadine" Healthcare 13, no. 11: 1270. https://doi.org/10.3390/healthcare13111270

APA Style

Puigdellívol-Sánchez, A., Juanes-González, M., Calderón-Valdiviezo, A. I., Losa-Puig, H., González-Salvador, M., León-Pérez, M., Pueyo-Antón, L., Franco-Romero, M., Lozano-Paz, C., Cortés-Borra, A., & Valls-Foix, R. (2025). COVID-19 Pandemic Waves and 2024–2025 Winter Season in Relation to Angiotensin-Converting Enzyme Inhibitors, Angiotensin Receptor Blockers and Amantadine. Healthcare, 13(11), 1270. https://doi.org/10.3390/healthcare13111270

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