Efficacy and Safety of ACEIs/ARBs in Patients with COVID-19 Combined with Chronic Kidney Disease: a Protocol for Systematic Review and Meta-analysis

Abstract Background: Despite the control measure taken against the coronavirus disease 2019(COVID-19) at global level, the pandemic has started to rebound and transmitted rapidly worldwide due to the delta strain. This strain is more virulent than the original severe acute respiratory syndrome coronavirus 2 virus. The approved vaccines or drugs can reduce mortality; still various efforts are being made to seek a complete cure. Currently, it remains controversial whether angiotensin-converting enzyme inhibitors/angiotensin receptor blockers (ACEIs/ARBs) are useful in managing COVID-19 patients having comorbidities like chronic kidney disease(CKD). Evidence concerning the application of ACEIs/ARBs needs to be established through advanced meta-analyses and systematic reviews.Methods/design:This study is designed following the PRISMA (Preferred Reporting Items of Systematic Reviews and Meta-Analyses). The studies published from December 1, 2019, to August 31, 2021 will be considered. The primary databases such as Cochrane Library, MEDLINE, EMBASE, and Chinese Biomedical Literature Database will be included, and meeting records and grey literature databases will be retrieved to compare at least two terminations or discontinued ACEIs or ARBs in clinical intervention studies. The primary results will include kidney function biomarkers, blood pressure, and long-term mortality or hospital admission severity. Pairwise random effects and meta-analyses will be performed for the selected literature using RevMan (V.5.3). The bias risk evaluation, heterogeneity, consistency, transitivity, and evidence quality will be followed as described in the Cochrane Handbook for Systematic Reviews of Interventions suggestions.Discussion: This review will use a structured and effective method to analyze the effectiveness and security of ACEIs and ARBs in treating COVID-19 patients with CKD. Research results can present valuable evidence for patients, clinicians, researchers, or decision-makers.Systerm review: PROSPERO registration number CRD42021268701.