The following article is part of our coverage of the Endocrine Society’s annual meeting (ENDO 2021) that is being held virtually from March 20-23, 2021. Endocrinology Advisor‘s staff will report on the top research in hormone science and clinical care. Check back for the latest news from ENDO 2021.

 

A history of renin-angiotensin-aldosterone system (RAAS) antagonism may be associated with less severe coronavirus disease 2019 (COVID-19) among patients with obesity-related hypertension that requires hospitalization, according to research recently presented at the annual meeting of the Endocrine Society (ENDO) 2021 conference, held virtually from March 20 to 23, 2021.


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This retrospective study included 138 inpatients with COVID-19 admitted between March 1 and July 8, 2020. All participants had hypertension, were classified as either overweight (body mass index [BMI] ≥25 kg/m2) or obese (BMI ≥30 kg/m2), and were treated as outpatients with or without angiotensin converting enzyme inhibitors (ACEIs) or angiotensin receptor blockers (ARBs).

The control group (n=59) was composed of individuals who had not been exposed to RAAS antagonists, while the larger cohort (n=79) was composed of those treated with ACEIs/ARBs. The ACEI/ARB cohort contained 24% women, compared with 47% in the control group. The ACEI/ARB cohort also had a higher rate of diabetes (ACEI/ARB 63.2%; control 45.7%).

Researchers assessed both severity and mortality of COVID-19 by the use of noninvasive and mechanical ventilation, extracorporeal membrane oxygenation (ECMO), supplemental oxygen, and vasopressors. Compared with the ACEI/ARB group, the control group exhibited higher mortality (ACEI/ARB 15.1%; control 32.2%) and intensive care unit admissions (ACEI/ARB 46.8%; control 57.6%), as well as higher use of mechanical ventilation (ACEI/ARB 1.2%; control 37.2%), vasopressors (ACEI/ARB 31.6%; control 38.9%), and supplemental oxygen (ACEI/ARB 49.3%; control 52.5%). However, the control group had lower rates of both noninvasive ventilation (ACEI/ARB 20.2%; control 18.6%) and ECMO (ACEI/ARB 20.2%; control 0%).

The study authors concluded that the severity and mortality of COVID-19 are lower among those individuals with obesity-related hypertension and a history of RAAS antagonism who required hospitalization.

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Reference

Kamalumpundi V, Shams E, Cheng L, et al. Patients with obesity-related hypertension treated with renin-angiotensin-aldosterone system antagonists exhibit lower mortality and less severe COVID-19: a retrospective study. Poster presented at: Endocrine Society (ENDO) 2021 virtual conference; March 20-23, 2021. Session P12.