Beta receptor blocker therapy for the elderly in the COVID-19 era

Table 1 Studies on beta blocker therapy and coronavirus disease 2019 in elderly patients

Ref.	Study type	Study aim	Subjects	Study findings
Yan F et al[49], 2020	Multicenter retrospective	Examine association between clinical outcomes with the use of antihypertensive drugs	665 hypertensive COVID-19 patients (mean age: 64.6 ± 11.8 yr)	Reduced dyspnea in BB users; improved clinical indices
Rey JR et al[53], 2020	Prospective	Study cardiovascular outcomes in patients with COVID-19 and a prior diagnosis of heart failure	3080 hospitalized COVID-19 patients (mean age: 62.3 ± 20.3 yr)	↑ in-hospital mortality associated to withdrawal of BB (HR: 4.15; 95%CI: 1.61–10.71)
Liu Y et al[54], 2020	Retrospective	Association between antihypertensive use and disease severity of COVID-19 patients	46 elderly hypertensive COVID-19 patients (> 65 yr in age)	BB use not associated to less disease severity (OR: 0.49; 95%CI: 0.2–1.98)
Saifi Said E et al[51], 2021	Retrospective	Examine factors associated with survival in older people with COVID-19	34 inpatients with COVID-19 ( 90 yr in age)	Better survival in patients treated with BB vs non-treated (P = 0.008 by Kaplan-Meier analysis)
Couchana L et al[52], 2021	Retrospective multicenter cohort study	Investigate association between antihypertensive agent use and in-hospital mortality	8078 patients hospitalized for COVID-19 (median age: 75.4 yr)	↓Risk of mortality in BB users (aOR: 0.80; 95%CI: 0.67-0.95)
Clemente-Moragón A et al[56], 2021	Pilot randomized controlled trial	Evaluate the effects of intravenous metoprolol on lung inflammation and oxygenation	20 COVID-19 patients with ARDS (median age: 60 yr)	Intravenous metoprolol reduced lung inflammation, improved oxygenation, and was safe
Blanc F et al[55], 2021	Retrospective case-control	Find a pharmacological preventive treatment of COVID-19 in elderly patients	89 COVID-19 patients (mean age: 84.4 yr) compared with 90 non-COVID-19 patients (mean age: 83.8 yr); 40.78% on BB therapy	taking BB does not reduce risk of COVID-19 infection (OR: 1.28; 95%CI: 0.71–2.31, P = 0.7909)
Vrillon A et al[47], 2020	Prospective cohort	Describe clinical features and outcome of COVID-19 elderly inpatients	76 COVID-19 inpatients (median age: 90 yr)	No difference in BB therapy between survivors vs non-survivors (P = 0.796)
Vila-Corcoles A et al[45], 2020	Population-based retrospective cohort	Investigate relationships between antihypertensive drug use and COVID-19 infection	34,936 ambulatory hypertensive adults (> 50 yr of age; mean age: 70.9 ± 11.3 yr)	Receiving BB did not significantly alter the risk of PCR-confirmed COVID-19 (HR: 0.97; 95%CI: 0.68-1.37, P = 0.844)
Polverino F et al[46], 2020	Nationwide observational retrospective	Whether hypertension medications may increase the risk of death	3179 COVID-19 inpatients (58% of patients ≥ 65 yr of age)	Hypertension medication does not significantly increase COVID-19-related deaths in an older population (OR: 0.85; 95%CI: 0.65–1.12, P = 0.244)

aOR: Adjusted odds ratio; ARDS: Acute respiratory distress syndrome; BB: Beta blocker; CI: Confidence interval; COVID: Coronavirus 2019 disease; HR: Hazard ratio; OR: Odds ratio.