Seniors with COVID-19 taking ACE inhibitors have lower hospitalization risk

A Yale-led study suggests that older COVID-19 patients taking ACE inhibitors for hypertension have a lower risk of hospitalization for the novel coronavirus.

The study is posted on the medical pre-print website medRxiv and has been submitted for peer-reviewed publication.

Researchers analyzed retrospective data from about 10,000 patients with hypertension who tested positive for SARS-CoV-2, the virus that causes COVID-19. All patients were enrolled in either Medicare Advantage or a commercially insured health care plan and had a prescription for at least one hypertension medication, such as angiotensin-converting enzyme (ACE) inhibitors or angiotensin receptor blockers (ARB).

The use of ACE inhibitors was associated with an almost 40% lower risk of COVID-19 hospitalization for the older, Medicare Advantage patients — but there was no significant difference in risk for the younger, commercially insured patients.

The use of ARBs was not associated with a lower risk for COVID-19 hospitalization for either group. Also, neither ARBs nor ACE inhibitors were associated with a lower mortality risk in people hospitalized with COVID-19.

“While not yet actionable, these findings provide an impetus to test whether this common, inexpensive class of drugs can mitigate the impact of the virus,” said Dr. Harlan Krumholz, the Harold H. Hines Jr. Professor of Medicine at Yale and director of the Yale New Haven Hospital Center for Outcomes Research.

Krumholz is co-senior author of the study, along with Dr. Deneen Vojta, executive director of research and development for the Minnesota-based company UnitedHealth Group. Krumholz said a large-scale clinical trial is being prepared to examine the potential role of ACE inhibitors in preventing the most severe consequences of COVID-19.

The researchers said the study was prompted by unresolved gaps in scientific knowledge that have led to debate over how ACE inhibitors and ARBs affect COVID-19 patients.

Dr. Rohan Khera, who will be joining Yale later this year from the University of Texas Southwestern, is co-first author of the study. Yale co-authors are Yuan Lu, Erica Spatz, Karthik Murugiah, Zhenqiu Lin, and Saad Omer.

UnitedHealth Group funded the research.