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We systematically searched PubMed, the Cochrane Library, the Web of Science, EMBASE, medRxiv, and bioRxiv database through October 30, 2020. The primary and secondary outcomes were mortality and severe COVID\u201019, respectively. We included 25 studies with 22,734 COVID\u201019 patients, and we compared the outcomes between patients who did and did not receive angiotensin\u2010converting enzyme inhibitors\/angiotensin receptor blockers (ACEIs\/ARBs). The use of ACEIs\/ARBs was not associated with higher risks of severe disease (odds ratio [OR]\u2009=\u20090.89; 95% confidence interval [CI]: 0.63, 1.15; <jats:italic>I<\/jats:italic><jats:sup>2<\/jats:sup>\u2009=\u200938.55%), mechanical ventilation (OR\u2009=\u20090.89; 95% CI: 0.61, 1.16; <jats:italic>I<\/jats:italic><jats:sup>2<\/jats:sup>\u2009=\u20093.19%), dialysis (OR\u2009=\u20091.24; 95% CI: 0.09, 2.39; <jats:italic>I<\/jats:italic><jats:sup>2<\/jats:sup>\u2009=\u20090.00%), or the length of hospital stay (SMD\u2009=\u20090.05; 95% CI: \u22120.16, 0.26; <jats:italic>I<\/jats:italic><jats:sup>2<\/jats:sup>\u2009=\u200984.43%) in COVID\u201019 patients. The effect estimates showed an overall protective effect of ACEIs\/ARBs against mortality (OR\u2009=\u20090.65; 95% CI: 0.46, 0.85; <jats:italic>I<\/jats:italic><jats:sup>2<\/jats:sup>\u2009=\u200973.37%), severity\/mortality (OR\u2009=\u20090.69; 95% CI: 0.43, 0.95; <jats:italic>I<\/jats:italic><jats:sup>2<\/jats:sup>\u2009=\u200922.90%), transfer to the intensive care unit among COVID\u201019 patients with hypertension (OR\u2009=\u20090.36, 95% CI: 0.19, 0.53, <jats:italic>I<\/jats:italic><jats:sup>2<\/jats:sup>\u2009=\u20090.00%), hospitalization (OR\u2009=\u20090.79; 95% CI: 0.60, 0.98; <jats:italic>I<\/jats:italic><jats:sup>2<\/jats:sup>\u2009=\u20090.00%), and acute respiratory distress syndrome (OR\u2009=\u20090.71; 95% CI: 0.46, 0.95; <jats:italic>I<\/jats:italic><jats:sup>2<\/jats:sup>\u2009=\u20090.00%). The use of RAAS inhibitor was not associated with increased mortality or disease severity in COVID\u201019 patients. This study supports the current guidelines that discourage the discontinuation of RAAS inhibitors in COVID\u201019 patients.<\/jats:p>","DOI":"10.1002\/jmv.26695","type":"journal-article","created":{"date-parts":[[2020,11,24]],"date-time":"2020-11-24T21:41:16Z","timestamp":1606254076000},"page":"2287-2300","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":22,"title":["Effects of renin\u2010angiotensin\u2010aldosterone system\u00a0inhibitors on disease severity and mortality in patients with COVID\u201019: A meta\u2010analysis"],"prefix":"10.1002","volume":"93","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9052-5980","authenticated-orcid":false,"given":"Guoyue","family":"Zhang","sequence":"first","affiliation":[{"name":"Respiratory Medicine Department, The Second Affiliated Hospital, College of Medicine Chongqing Medical University Chongqing 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