Meta-analysis Of The Effect Of ACEI/ARB On COVID-19 Infection Rate And Prognosis

Objective:To systematically evaluate the effects of taking angiotensin converting enzyme inhibitors or angiotensin receptor antagonists on COVID-19 infection rate,severe disease rate and mortality rate,respectively,and to provide evidence for whether ACEI/ ARBs can be continued in the post-epidemic era.Methods:Multiple Chinese and English databases were searched comprehensively,including PubMed database,the Cochrane Central Register of Controlled Trials,Chinese Biological Medical Datebase,China National Knowledge Infrastructure.According to the inclusion and exclusion criteria,31 articles were selected.There are13 articles related infection rate by reading the full text,17 articles related to severe rate,and 16 papers associated with mortality rate.According to taking ACEI and ARB and ACEI/ARB,extract related data,respectively.Then using Rev Man 5.3 to statistical analysis and heterogeneity test.Small heterogeneity between groups was given fixed effect model to calculate the combined statistics.With large heteroge-neity was given subgroup to analyze the conditions of hypertension populations and general populations,while still large heterogeneity was used for random effect model to calculate the statistics.Results:1.Among the 13 literatures on ACEI or ARB use and COVID-19 infection rate including 29 studies data,11 studies were ACEI users,and there was no increase in COVID-19 infection rate compared with those who did not take ACEI;10 studies were ARB users,and there was no increase in infection rate compared with those who did not take ARB;8 studies were ACEI/ARB users,showed there was no correlation between ACEI/ARB users and those without ACEI/ARB users in COVID-19 infection rate.2.Among the 17 literatures on ACEI or ARB use and COVID-19 severe disease rate including 29 studies data,7 studies were ACEI users,and there was no increase in COVID-19 severe disease rate compared with those who did not take ACEI;7studies were ARB users,and there was no increase in severe disease rate compared with those who did not take ARB;15 studies were ACEI/ARB users,showed there was no correlation between ACEI/ARB users and those without ACEI/ARB users in COVID-19 severe disease rate.3.Among the 16 literatures on ACEI or ARB use and COVID-19 mortality rate including 27 studies data,6 studies were ACEI users,and there was no increase in COVID-19 mortality rate compared with those who did not take ACEI;6 studies were ARB users,and there was no increase in mortality rate compared with those who did not take ARB;15 studies were ACEI/ARB users,showed there was no correlation between ACEI/ARB users and those without ACEI/ARB users in COVID-19 mortality rate.Conclusion:Neither ACEI nor ARB increased COVID-19 infection rate,severe disease rate or mortality rate.And ACEI/ARB is very important for patients with cardiovascular system diseases.ACEI/ARB drugs can still be taken in the post-epidemic era.