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자료유형
학술저널
저자정보
Kim Jaiyong (Institute of Artificial Intelligence and Big Data in Medicine Yonsei University Wonju College of Me) 김동욱 (국민건강보험공단) 김광일 (서울대학교) Kim Hong Bin (Division of Infectious Diseases Department of Internal Medicine Seoul National University College o) Kim Jong-Hun (Department of Social and Preventive Medicine Sungkyunkwan University School of Medicine Suwon Korea) Lee Yong-Gab (Health Insurance Policy Research Institute National Health Insurance Service Wonju Korea.) 변경향 (한양대학교 건강과사회연구소) 정해관 (성균관대학교) Korean Society of Hypertension (Korean Society of Hypertension)
저널정보
대한의학회 Journal of Korean Medical Science Journal of Korean Medical Science Vol.35 No.25
발행연도
2020.1
수록면
1 - 12 (12page)

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Background: There is a controversy whether it is safe to continue renin-angiotensin system blockers in patients with coronavirus disease 2019 (COVID-19). We analyzed big data to investigate whether angiotensin-converting enzyme inhibitors and/or angiotensin II receptor blockers have any significant effect on the risk of COVID-19. Population-based cohort study was conducted based on the prescription data from nationwide health insurance records. Methods: We investigated the 1,374,381 residents aged ≥ 40 years living in Daegu, the epicenter of the COVID-19 outbreak, between February and March 2020. Prescriptions of antihypertensive medication during the year before the outbreak were extracted from the National Health Insurance Service registry. Medications were categorized by types and stratified by the medication possession ratios (MPRs) of antihypertensive medications after controlling for the potential confounders. The risk of COVID-19 was estimated using a difference in difference analysis. Results: Females, older individuals, low-income earners, and recently hospitalized patients had a higher risk of infection. Patients with higher MPRs of antihypertensive medications had a consistently lower risk of COVID-19 than those with lower MPRs of antihypertensive medications and non-users. Among patients who showed complete compliance, there was a significantly lower risk of COVID-19 for those prescribed angiotensin II receptor blockers (relative risk [RR], 0.751; 95% confidence interval [CI], 0.587–0.960) or calcium channel blockers (RR, 0.768; 95% CI, 0.601–0.980). Conclusion: Renin-angiotensin system blockers or other antihypertensive medications do not increase the risk of COVID-19. Patients should not stop antihypertensive medications, including renin-angiotensin system blockers, because of concerns of COVID-19.

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