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Use of drugs for hypertension or heart failure and the risk of death in COVID-19: association with loop-diuretics
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- Fastbom, Johan (författare)
- Natl Board Hlth & Welf Socialstyrelsen, Sweden; Karolinska Inst, Sweden; Stockholm Univ, Sweden
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- Jonasdottir Bergman, Gudrun (författare)
- Natl Board Hlth & Welf Socialstyrelsen, Sweden
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- Holm, Johanna (författare)
- Natl Board Hlth & Welf Socialstyrelsen, Sweden
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- 2024
- 2024
- Engelska.
- Ingår i: European Journal of Clinical Pharmacology. - : SPRINGER HEIDELBERG. - 0031-6970 .- 1432-1041.
- Tidskriftsartikel (refereegranskat)
Abstract
Ämnesord
Stäng
- Purpose To study the association between the use of drugs for hypertension or heart failure, particularly diuretics, and risk of death in COVID-19.Methods We conducted a cohort study, based on record linked individual-based data from national registers, of all Swedish inhabitants 50 years and older (n = 3,909,321) at the start of the first SARS-CoV-2 wave in Sweden. The association between use of angiotensin-converting enzyme inhibitors (ACEI), angiotensin II receptor blockers (ARB), thiazides, loop diuretics, aldosterone antagonists, beta blocking agents and calcium channel blockers at the index date 6 March 2020, and death in COVID-19 during 7 March to 31 July 2020, was analysed using Cox-proportional hazards regression, adjusted for a wide range of possible confounders.Results Use of loop diuretics was associated with higher risk [adjusted hazard ratio (HR) 1.26; 95% confidence interval (95% CI) 1.17-1.35] and thiazides with reduced risk (0.78; 0.69-0.88) of death in COVID-19. In addition, lower risk was observed for ACEI and higher risk for beta-blocking agents, although both associations were weak. For ARB, aldosterone antagonists and calcium channel blockers no significant associations were found.Conclusion In this nationwide cohort of nearly 4 million persons 50 years and older, the use of loop diuretics was associated with increased risk of death in COVID-19 during the first SARS-CoV-2 wave in Sweden. This contrasted to the decreased risk observed for thiazides. As treatment with loop diuretics is common, particularly in the elderly, the group most affected by severe COVID-19, this finding merit further investigation.
Ämnesord
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Kardiologi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Cardiac and Cardiovascular Systems (hsv//eng)
Nyckelord
- COVID-19; Loop diuretics; Thiazide diuretics; Angiotensin-converting enzyme inhibitors
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