Primary endpoint: death within 30 days for 18.1% of patients in the ACE inhibitor/ARB group vs. 7.3% in the non-user group, but association not significant after adjustment for age, sex and medical history (adjusted risk ratio [HR], 0.83 [95% CI: 0.67-1.03]).
Secondary endpoint: death or severe IDVOC-19 at 30 days occurred in 31.9% of patients in the ACE/ARA group versus 14.2% of non-users (adjusted HR 1.04 [95% CI 0.89-1.23]).
The use of ACE inhibitor/ARB compared to other antihypertensive agents was not significantly associated with a higher incidence of COVID-19 (adjusted HR 1.05 [95% CI 0.80-1.36]).
Among patients diagnosed with COVID-19, this study found no significant association between prior ACE inhibitor use and mortality or severe COVID-19 after adjustment for baseline demographics and co-morbidities.
In sensitivity analyses, the use of ACE inhibitors/ARAs was not associated with a higher incidence of COVID-19 diagnosis compared to users of other antihypertensive drugs.
Observational study
Retrospective Danish population-wide cohort study, n=4,480.
Case-control study nested within this study
Inclusion of patients on ICD-10 (with coding quality assessment on 98 hospital records, 97 with positive RT-PCR).
Inclusion of patients only in hospital
Hypertension defined by the use of more than one antihypertensive drug (but prescription possible for other reasons). Patients with hypertensive medications for chronic renal failure or heart failure were excluded from the nested case-control study.
Short follow-up
Primary endpoint: death
Secondary endpoint: composite endpoint death or severe VID19
Endpoint: Diagnosis of COVID-19
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