149 Association of ACE-I and ARB Prescriptions With Mortality in Patients Admitted to the Hospital With COVID-19 in New York City

Study Objectives: For several weeks in March and April 2020, New York City was the global epicenter of the COVID-19 outbreak Minority populations in the Bronx were disproportionately affected Since the beginning of the outbreak, there has been speculation that angiotensin-converting enzyme inhibitors (ACE-Is) and angiotensin receptor blockers (ARBs) may worsen outcomes among patients with COVID-19 Methods: This was a retrospective case series We included patients >= 16 years with COVID-19 who presented to one of five EDs between March 9, 2020 and April 4, 2020 in the New York City borough of the Bronx The population was largely Black and Hispanic Included were 1,122 laboratory-confirmed cases of COVID-19, and 22 COVID-negative cases in which the clinical suspicion for disease remained high despite negative testing Laboratory confirmation of COVID-19 was performed with reverse-transcriptase polymerase chain reaction (RT-PCR) assays on nasopharyngeal swab specimens We abstracted data from the medical record on whether the patient had a current prescription for an ACE-I or ARB, as well as data on hypertension (HTN), diabetes (DM), chronic kidney disease (CKD), and congestive heart failure (CHF) Clinical outcomes included death, ICU admission, and need for renal replacement therapy (RRT) We determined inter-rater reliability for 10% of the data We report Spearman’s rho and p values for each variable and clinical outcomes We performed a logistic regression model in which death was the primary outcome and each of the predictor variables listed above were entered and retained in the model P = 16 years old admitted to the hospital with COVID-19 after controlling for medical comorbidities