Prescribing Trend of Renin-Angiotensin System Blocking Drugs during COVID-19 Pandemic: a Retrospective Cohort Study

It is known from a recent study that SARS-COV2 (COVID 19) virus had a high affinity for an-giotensin converting enzyme 2 (ACE2), which increased human-to-human transmission. Users of angiotensin converting enzyme inhibitors (ACEI) have higher ACE2 receptor expression, raising concerns about ACEI safety in COVID19 patients and whether their use predisposes to the disease. The aim of this study was to test the pattern of prescriptions for these drugs in the United Kingdom. This retrospective cohort study observed renin-angiotensin system (RAS) blocking drug prescribing patterns in the United Kingdom. From April 2018 to December 2021, primary care prescribing data for RAS blocking drugs were collected in England, Wales, and Northern Ireland. Before April 2020, the rate of RAS blocking drugs prescribing was similar to the rate after April 2020 in England (median difference = 0.651, p value = 0.607) and Wales (median difference = 6.508, p value = 0.591). However, after April 2020, the prescribing rate in Northern Ireland was significantly lower (median difference = 36.136, p value = 0.002). Except for Northern Ireland, there was no difference in the use of renin-angiotensin system blocking drugs following the April 2020 study. Other studies using patient-level data should be conducted to investigate why Northern Ireland differs from the rest of the UK.