{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,14]],"date-time":"2025-12-14T09:30:57Z","timestamp":1765704657754,"version":"3.48.0"},"reference-count":33,"publisher":"BMJ","issue":"4","license":[{"start":{"date-parts":[[2022,4,12]],"date-time":"2022-04-12T00:00:00Z","timestamp":1649721600000},"content-version":"unspecified","delay-in-days":11,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"name":"National Center for Advancing Translational Sciences of the National Institutes of Health","award":["UL1TR001417"],"award-info":[{"award-number":["UL1TR001417"]}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2022,3,20]]},"published-print":{"date-parts":[[2022,4]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To describe the clinical outcomes of COVID-19 in a racially diverse sample from the US Southeast and examine the association of renin\u2013angiotensin\u2013aldosterone system (RAAS) inhibitor use with COVID-19 outcome.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design, Setting, Participants<\/jats:title>\n                    <jats:p>This study is a retrospective cohort of 1024 patients with reverse-transcriptase PCR-confirmed COVID-19 infection, admitted to a 1242-bed teaching hospital in Alabama. Data on RAAS inhibitors use, demographics and comorbidities were extracted from hospital medical records.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Primary outcomes<\/jats:title>\n                    <jats:p>In-hospital mortality, a need of intensive care unit, respiratory failure, defined as invasive mechanical ventilation (iMV) and 90-day same-hospital readmissions.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Among 1024 patients (mean (SD) age, 57 (18.8) years), 532 (52.0%) were African Americans, 514 (50.2%) male, 493 (48.1%) had hypertension, 365 (36%) were taking RAAS inhibitors. During index hospitalisation (median length of stay of 7 (IQR (4\u201315) days) 137 (13.4%) patients died; 170 (19.2%) of survivors were readmitted. RAAS inhibitor use was associated with lower in-hospital mortality (adjusted HR, 95% CI (0.56, (0.36 to 0.88), p=0.01) and no effect modification by race was observed (p for interaction=0.81). Among patients with hypertension, baseline RAAS use was associated with reduced risk of iMV, adjusted OR, 95% CI (aOR 0.58, 95% CI 0.36 to 0.95, p=0.03). Patients with heart failure were twice as likely to die from COVID-19, compared with patients without heart failure.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>In a retrospespective study of racially diverse patients, hospitalised with COVID-19, prehospitalisation use of RAAS inhibitors was associated with 40% reduction in mortality irrespective of race.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2021-053961","type":"journal-article","created":{"date-parts":[[2022,4,12]],"date-time":"2022-04-12T13:43:09Z","timestamp":1649770989000},"page":"e053961","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":1,"title":["What is the association of renin\u2013angiotensin\u2013aldosterone system inhibitors with COVID-19 outcomes: retrospective study of racially diverse patients?"],"prefix":"10.1136","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5848-8019","authenticated-orcid":false,"given":"Yulia","family":"Khodneva","sequence":"first","affiliation":[{"name":"Department of Medicine, Heersink School of Medicine, UAB, Birmingham, Alabama, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gargya","family":"Malla","sequence":"additional","affiliation":[{"name":"Department of Epidemiology, School of Public Health, UAB, Birmingham, Alabama, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stephen","family":"Clarkson","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Department of Medicine, Heersink School of Medicine, UAB, Birmingham, Alabama, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Richard","family":"Fu","sequence":"additional","affiliation":[{"name":"Department of Medicine, Heersink School of Medicine, UAB, Birmingham, Alabama, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Monika M","family":"Safford","sequence":"additional","affiliation":[{"name":"Department of Medicine, Weill Cornell Medicine, New York, New York, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Parag","family":"Goyal","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Department of Medicine, Weill Cornell Medicine, New York, New York, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Suzanne","family":"Oparil","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Department of Medicine, Heersink School of Medicine, UAB, Birmingham, Alabama, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andrea L","family":"Cherrington","sequence":"additional","affiliation":[{"name":"Department of Medicine, Heersink School of Medicine, UAB, Birmingham, Alabama, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Elizabeth A","family":"Jackson","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Department of Medicine, Heersink School of Medicine, UAB, Birmingham, Alabama, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"James","family":"Willig","sequence":"additional","affiliation":[{"name":"Department of Medicine, Heersink School of Medicine, UAB, Birmingham, Alabama, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2022,4,12]]},"reference":[{"key":"2025121401273299000_12.4.e053961.1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMe2002387"},{"key":"2025121401273299000_12.4.e053961.2","doi-asserted-by":"crossref","first-page":"531","DOI":"10.1007\/s00392-020-01626-9","article-title":"Prevalence and impact of cardiovascular metabolic diseases on COVID-19 in China","volume":"109","author":"Li","year":"2020","journal-title":"Clin Res Cardiol"},{"key":"2025121401273299000_12.4.e053961.3","doi-asserted-by":"crossref","first-page":"125","DOI":"10.3855\/jidc.12600","article-title":"Similarity in case fatality rates (cfr) of COVID-19\/SARS-COV-2 in Italy and China","volume":"14","author":"Porcheddu","year":"2020","journal-title":"J Infect Dev Ctries"},{"key":"2025121401273299000_12.4.e053961.4","doi-asserted-by":"crossref","unstructured":"Yang J , Zheng Y , Gou X . 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