{"@context":{"@vocab":"https://cir.nii.ac.jp/schema/1.0/","rdfs":"http://www.w3.org/2000/01/rdf-schema#","dc":"http://purl.org/dc/elements/1.1/","dcterms":"http://purl.org/dc/terms/","foaf":"http://xmlns.com/foaf/0.1/","prism":"http://prismstandard.org/namespaces/basic/2.0/","cinii":"http://ci.nii.ac.jp/ns/1.0/","datacite":"https://schema.datacite.org/meta/kernel-4/","ndl":"http://ndl.go.jp/dcndl/terms/","jpcoar":"https://github.com/JPCOAR/schema/blob/master/2.0/"},"@id":"https://cir.nii.ac.jp/crid/1360855569249067904.json","@type":"Article","productIdentifier":[{"identifier":{"@type":"DOI","@value":"10.1038/s41440-020-00535-8"}},{"identifier":{"@type":"URI","@value":"https://www.nature.com/articles/s41440-020-00535-8.pdf"}},{"identifier":{"@type":"URI","@value":"https://www.nature.com/articles/s41440-020-00535-8"}},{"identifier":{"@type":"PMID","@value":"32820236"}}],"dc:title":[{"@value":"Renin–angiotensin system inhibitors and the severity of coronavirus disease 2019 in Kanagawa, Japan: a retrospective cohort study"}],"description":[{"notation":[{"@value":"Since the beginning of the coronavirus disease 2019 (COVID-19) outbreak initiated on the Diamond Princess Cruise Ship at Yokohama harbor in February 2020, we have been doing our best to treat COVID-19 patients. In animal experiments, angiotensin converting enzyme inhibitors (ACEIs) and angiotensin II type-1 receptor blockers (ARBs) are reported to suppress the downregulation of angiotensin converting enzyme 2 (ACE2), and they may inhibit the worsening of pathological conditions. We aimed to examine whether preceding use of ACEIs and ARBs affected the clinical manifestations and prognosis of COVID-19 patients. One hundred fifty-one consecutive patients (mean age 60 ± 19 years) with polymerase-chain-reaction proven severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection who were admitted to six hospitals in Kanagawa Prefecture, Japan, were analyzed in this multicenter retrospective observational study. Among all COVID-19 patients, in the multiple regression analysis, older age (age ≥ 65 years) was significantly associated with the primary composite outcome (odds ratio (OR) 6.63, 95% confidence interval (CI) 2.28-22.78, P  0.001), which consisted of (i) in-hospital death, (ii) extracorporeal membrane oxygenation, (iii) mechanical ventilation, including invasive and noninvasive methods, and (iv) admission to the intensive care unit. In COVID-19 patients with hypertension, preceding ACEI/ARB use was significantly associated with a lower occurrence of new-onset or worsening mental confusion (OR 0.06, 95% CI 0.002-0.69, P = 0.02), which was defined by the confusion criterion, which included mild disorientation or hallucination with an estimation of medical history of mental status, after adjustment for age, sex, and diabetes. In conclusion, older age was a significant contributor to a worse prognosis in COVID-19 patients, and ACEIs/ARBs could be beneficial for the prevention of confusion in COVID-19 patients with hypertension."}]}],"creator":[{"@id":"https://cir.nii.ac.jp/crid/1410001204430727043","@type":"Researcher","personIdentifier":[{"@type":"NRID","@value":"9000412588842"},{"@type":"NRID","@value":"9000410904753"},{"@type":"NRID","@value":"9000262372237"},{"@type":"NRID","@value":"9000004277456"},{"@type":"NRID","@value":"9000414561599"},{"@type":"NRID","@value":"9000409501302"},{"@type":"NRID","@value":"9000404639471"},{"@type":"NRID","@value":"9000409645048"},{"@type":"NRID","@value":"9000257809524"},{"@type":"NRID","@value":"9000314067177"},{"@type":"NRID","@value":"9000263055167"},{"@type":"NRID","@value":"9000019184196"},{"@type":"NRID","@value":"9000283343973"},{"@type":"NRID","@value":"9000402615664"},{"@type":"NRID","@value":"9000409476637"},{"@type":"NRID","@value":"9000410511982"},{"@type":"NRID","@value":"9000243877765"},{"@type":"NRID","@value":"9000258740825"},{"@type":"NRID","@value":"9000413780197"},{"@type":"NRID","@value":"9000412012723"},{"@type":"NRID","@value":"9000345303232"},{"@type":"RESEARCHMAP","@value":"https://researchmap.jp/7000015762"}],"foaf:name":[{"@value":"Yasushi 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LLC"}],"prism:publicationDate":"2020-08-21","prism:volume":"43","prism:number":"11","prism:startingPage":"1257","prism:endingPage":"1266"},"reviewed":"false","dcterms:accessRights":"http://purl.org/coar/access_right/c_abf2","dc:rights":["https://www.springer.com/tdm","https://www.springer.com/tdm"],"url":[{"@id":"https://www.nature.com/articles/s41440-020-00535-8.pdf"},{"@id":"https://www.nature.com/articles/s41440-020-00535-8"}],"createdAt":"2020-08-21","modifiedAt":"2021-08-20","foaf:topic":[{"@id":"https://cir.nii.ac.jp/all?q=Adult","dc:title":"Adult"},{"@id":"https://cir.nii.ac.jp/all?q=Male","dc:title":"Male"},{"@id":"https://cir.nii.ac.jp/all?q=Physiology","dc:title":"Physiology"},{"@id":"https://cir.nii.ac.jp/all?q=Pneumonia,%20Viral","dc:title":"Pneumonia, Viral"},{"@id":"https://cir.nii.ac.jp/all?q=Angiotensin-Converting%20Enzyme%20Inhibitors","dc:title":"Angiotensin-Converting Enzyme 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Clinical Features of COVID-19 in the Aspects of Thrombus, Gerontology, and Therapeutics for Hypertension"},{"@language":"ja","@value":"VIII．臨床像：血栓・老年内科・高血圧治療の立場から"},{"@value":"臨床像 : 血栓・老年内科・高血圧治療の立場から"},{"@language":"ja-Kana","@value":"リンショウゾウ : ケッセン ・ ロウネン ナイカ ・ コウケツアツ チリョウ ノ タチバ カラ"}]},{"@id":"https://cir.nii.ac.jp/crid/1390012313364318592","@type":"Article","resourceType":"学術雑誌論文(journal article)","relationType":["isReferencedBy"],"jpcoar:relatedTitle":[{"@language":"en","@value":"The Proportion of Long-term Response to Anti-N IgG Antibody after 12 Months for COVID-19 Subclinical Infections and a Longitudinal Survey for COVID-19 Subclinical Infections in 2021"}]},{"@id":"https://cir.nii.ac.jp/crid/1390288448339688448","@type":"Article","relationType":["isReferencedBy"],"jpcoar:relatedTitle":[{"@language":"en","@value":"Myocardial injury in COVID-19"},{"@language":"ja","@value":"COVID-19に伴う心筋障害"}]},{"@id":"https://cir.nii.ac.jp/crid/1390572244891370496","@type":"Article","resourceType":"学術雑誌論文(journal article)","relationType":["isReferencedBy"],"jpcoar:relatedTitle":[{"@language":"en","@value":"Study on Continuation of Antibody Prevalence Six Months after Detection of Subclinical Severe Acute Respiratory Syndrome Coronavirus 2 Infections"}]},{"@id":"https://cir.nii.ac.jp/crid/1390583934056295168","@type":"Article","resourceType":"学術雑誌論文(journal article)","relationType":["isReferencedBy"],"jpcoar:relatedTitle":[{"@language":"en","@value":"Clinical Course and Factors Correlated with Severe Morbidity and Mortality in Patients with Coronavirus Disease 2019 Undergoing Maintenance Dialysis in Kanagawa, Japan"}]},{"@id":"https://cir.nii.ac.jp/crid/1882273590500794496","@type":"Dataset","relationType":["references"],"jpcoar:relatedTitle":[{"@value":"Renin-angiotensin system inhibitors improve the clinical outcomes of COVID-19 patients with hypertension"}]},{"@id":"https://cir.nii.ac.jp/crid/2051151842062040832","@type":"Article","resourceType":"学術雑誌論文(journal article)","relationType":["isReferencedBy"],"jpcoar:relatedTitle":[{"@value":"Chronic kidney disease and clinical outcomes in patients with COVID-19 in Japan"}]}],"dataSourceIdentifier":[{"@type":"CROSSREF","@value":"10.1038/s41440-020-00535-8"},{"@type":"OPENAIRE","@value":"doi_dedup___::a67b94bd0aefd5cb356498b671e5c44b"},{"@type":"CROSSREF","@value":"10.2491/jjsth.32.303_references_DOI_4BLmEQnr4qVoQA97jCUC11PSMeR"},{"@type":"CROSSREF","@value":"10.1038/s41440-021-00832-w_references_DOI_4BLmEQnr4qVoQA97jCUC11PSMeR"},{"@type":"CROSSREF","@value":"10.1038/s41440-021-00641-1_references_DOI_4BLmEQnr4qVoQA97jCUC11PSMeR"},{"@type":"CROSSREF","@value":"10.1096/fj.202100016r_references_DOI_4BLmEQnr4qVoQA97jCUC11PSMeR"},{"@type":"CROSSREF","@value":"10.3390/biomedicines9030279_references_DOI_4BLmEQnr4qVoQA97jCUC11PSMeR"},{"@type":"CROSSREF","@value":"10.1038/s41440-022-01134-5_references_DOI_4BLmEQnr4qVoQA97jCUC11PSMeR"},{"@type":"CROSSREF","@value":"10.1016/j.jjcc.2022.04.001_references_DOI_4BLmEQnr4qVoQA97jCUC11PSMeR"},{"@type":"CROSSREF","@value":"10.2169/internalmedicine.4199-24_references_DOI_4BLmEQnr4qVoQA97jCUC11PSMeR"},{"@type":"CROSSREF","@value":"10.2169/internalmedicine.8019-21_references_DOI_4BLmEQnr4qVoQA97jCUC11PSMeR"},{"@type":"CROSSREF","@value":"10.2169/naika.109.2297_references_DOI_4BLmEQnr4qVoQA97jCUC11PSMeR"},{"@type":"CROSSREF","@value":"10.2169/internalmedicine.9628-22_references_DOI_4BLmEQnr4qVoQA97jCUC11PSMeR"},{"@type":"CROSSREF","@value":"10.1007/s10157-022-02240-x_references_DOI_4BLmEQnr4qVoQA97jCUC11PSMeR"}]}