Angiotensin converting enzymes inhibitors or angiotensin receptor blockers should be continued in COVID-19 patients with hypertension

Table 1 Patients’ characteristics and differences between discontinued angiotensin converting enzymes inhibitors or angiotensin receptor blockers group and other anti-hypertensive drugs group

Characteristic		Patients with both COVID-19 and hypertension		χ²/z	P value
	Total (n = 53)	Discontinued ACEIs/ARBs (n = 27)	Other anti-hypertensive drugs (n = 26)
Male sex, n (%)	26 (49.1)	15 (57.7)	11 (42.3)	0.930	0.335
Age, median yr (IQR)	67 (59, 73)	64 (55, 72)	70 (66, 73)	-2.369	0.018
Initial symptom, n (%)
Fever (temperature ≥ 37.3 °C)	35 (66)	19 (54.3)	16 (45.7)	6.895	0.1861
Cough	12 (22.6)	4 (33.3)	8 (66.7)
Dyspnea	1 (1.9)	0 (0)	1 (100)
Chest tension	1 (1.9)	0 (0)	1 (100)
Exhausted	1 (1.9)	1 (100)	0 (0)
Anorexia	1 (1.9)	1 (100)	0 (0)
Diarrhea	2 (3.8)	2 (100)	0 (0)
Severity of illness, n (%)
Moderate	24 (45.3)	12 (50)	12 (50)	0.016	0.901
Severe	29 (54.7)	15 (51.7)	14 (48.3)
qSOFA score, n (%)
0	26 (49.1)	17 (65.4)	9 (34.6)	4.259	0.039
≥ 1	27 (50.9)	10 (37)	17 (63)
CURB-65 score, n (%)
0	17 (32.1)	12 (70.6)	5 (29.4)	3.874	0.1451
1	28 (52.8)	12 (42.9)	16 (57.1)
≥ 2	8 (15.1)	3 (37.5)	5 (62.5)
Comorbidities, n (%)
Diabetes	21 (39.6)	10 (47.6)	11 (52.4)	0.154	0.695
Coronary heart disease-	13 (24.5)	8 (61.5)	5 (38.5)	0.774	0.379
Duration of hypertension, median-yr (IQR)	10 (5,16)	10 (6, 20)	10 (5, 10)	1.811	0.707
Chest CT results, n (%)
Bilateral lesions	48 (90.6)	24 (50)	24 (50)	0	1
Ground glass	32 (60.4)	15 (46.9)	17 (53.1)	0.535	0.465
Consolidation	6 (11.3)	4 (66.7)	2 (33.3)	0.148	0.701
Hydrothorax	5 (9.4)	2 (40)	3 (60)	0.002	0.965
Patch shadow	37 (69.8)	19 (51.4)	18 (48.6)	0.008	0.928
Laboratory tests, median (IQR)
White blood cell count, × 109/L	5.23 (4.56, 6.46)	5.22 (4.28, 6.99)	5.41 (4.76, 6.01)	-0.285	0.776
Lymphocyte count, × 109/L	0.99 (0.68, 1.49)	0.81 (0.61, 1.5)	1.05 (0.78, 1.49)	-1.228	0.219
Platelet count, × 109/L	247 (209, 285)	250 (202, 319)	247 (217, 280)	1.087	0.852
Hemoglobin, g/L	122 (115, 130)	122 (115, 129)	122 (115, 132)	-0.142	0.887
Alanine transaminase, U/L	21 (15, 31)	21 (14, 31)	20 (15, 30)	-0.027	0.979
Albumin, g/L	34.9 (31.3, 38.3)	33.4 (30.1, 35.9)	36.4 (31.7, 39)	-2.127	0.033
Total bilirubin, µmol/L	9.5 (7, 13.4)	9.1 (6.4, 13.4)	10.2 (7.4, 14.1)	-0.881	0.378
LDH, µmol/L	265 (228 ,313)	290 (228, 367)	262 (224, 300)	1.174	0.240
BUN, mmol/L	4.6 (3.4, 5.9)	4.6, (3.9, 6)	4.5 (3.2, 5.7)	0.854	0.393
Creatinine, µmol/L	71 (58, 90)	68 (59, 90)	71.5 (58, 90)	0.089	0.929
Prothrombin time, s	13.9 (13.2, 14.4)	13.8 (13.2, 14.3)	14 (13.2, 14.6)	-0.633	0.527
APTT, s	40.2 (35.6, 43.7)	40.8 (36.8, 44.6)	37.7 (35.3, 43.5)	1.148	0.251
Fibrous protein, g/L	4.81 (4, 6.18)	4.73 (4, 6.98)	4.85 (3.72, 6)	0.534	0.593
D-dimer, µg/L	0.93 (0.48, 1.77)	0.75 (0.47, 1.69)	1.11 (0.48, 1.81)	-0.409	0.682
hs-CRP, mg/L	21.2 (1.2, 81.4)	27.2 (5, 97.5)	16.6 (0.8, 57.9)	1.130	0.258
Procalcitonin, ng/mL	0.04 (0.02, 0.08)	0.04 (0.02, 0.06)	0.04 (0.02, 0.09)	0.290	0.772
Serum ferritin, µg/L	486 (328.35, 1023.85)	601.15 (387, 1173.3)	438.35 (321.4, 767.2)	1.244	0.213
IL-2R, U/mL	669 (445.5, 1013.5)	684.5 (488, 1172)	669 (407, 1010)	0.522	0.602
IL-6, pg/mL	8.76 (3.08, 37.12)	10.23 (3.91, 40.54)	7.66 (3.08, 34.24)	0.439	0.660
IL-8, pg/mL	13.35 (5.75, 23.2)	17.55 (7.4, 27.2)	10.4 (5.3, 18.9)	1.395	0.163
IL-10, pg/mL	5 (5, 5.45)	5 (5, 7.6)	5 (5, 5)	2.463	0.0142
hs-TnI, pg/mL	3.6 (2.9, 5.3)	4.5 (2.3, 7.6)	3.6 (3.6, 3.6)	1.090	0.267
Myoglobin, ng/mL	51.6 (37.8, 90)	50.7 (40, 134.6)	55.5 (31.8, 86.3)	0.365	0.715
CKMB, ng/mL	1.1 (0.5, 1.7)	1.2 (0.5, 1.9)	0.8 (0.5, 1.5)	0.508	0.611
NT-ProBNP, pg/mL	142.0 (71.0, 308.0)	113.0 (57.0, 311.0)	179.5 (75,0, 290.0)	-1.005	0.315
Time from onset to admission, median day (IQR)	14 (10, 18)	15 (10, 18)	12 (9, 18)	0.919	0.358

Only one patient's organ failure assessment (QSOFA) was 2, QSOFA for all other patients was 0 or 1. Therefore, QSOFA was involved as a binary variable (0, ≥1) in univariate and multivariate Cox proportional hazard model. ¹Chi-square test for continuity correction. ²Mean rank in the discontinued angiotensin converting enzymes inhibitors or angiotensin receptor blockers (ACEIs/ARBs) group = 30.73—slightly higher than that in the other anti-hypertensive drugs group (22.27). COVID-19: Coronavirus disease 2019; ACEIs/ARBs: Angiotensin converting enzymes inhibitors or angiotensin receptor blockers; qSOFA: Quick sequential organ failure assessment; LDH: Lactate dehydrogenase; BUN: Blood urea nitrogen; APTT: Activated partial thromboplastin time; hs-CRP: High-sensitive C-reactive protein; IL-2R: Interleukin-2 receptor; IL-6: Interleukin-6; IL-8: Interleukin-8; IL-10: Interleukin-10; hs-TnI: High sensitive cardiac troponin I; CKMB: Creatine phosphokinase isoenzyme; NT-ProBNP: N-terminal pro-brain natriuretic peptide; IQR: Interquartile range; CT: Computed tomography.