{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,5,13]],"date-time":"2025-05-13T21:46:50Z","timestamp":1747172810880,"version":"3.40.5"},"reference-count":33,"publisher":"Cambridge University Press (CUP)","issue":"1","license":[{"start":{"date-parts":[[2020,6,1]],"date-time":"2020-06-01T00:00:00Z","timestamp":1590969600000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J. Clin. Trans. Sci."],"published-print":{"date-parts":[[2021]]},"abstract":"<jats:title>Abstract<\/jats:title>\n\t  <jats:sec id=\"S2059866120004896_as1\">\n\t    <jats:title>Introduction:<\/jats:title>\n\t    <jats:p>There is significant interest in the use of angiotensin converting enzyme inhibitors (ACE-I) and angiotensin II receptor blockers (ARB) in coronavirus disease 2019 (COVID-19) and concern over potential adverse effects since these medications upregulate the severe acute respiratory syndrome coronavirus 2 host cell entry receptor ACE2. Recent studies on ACE-I and ARB in COVID-19 were limited by excluding outpatients, excluding patients by age, analyzing ACE-I and ARB together, imputing missing data, and\/or diagnosing COVID-19 by chest computed tomography without definitive reverse transcription polymerase chain reaction (RT-PCR), all of which are addressed here.<\/jats:p>\n\t  <\/jats:sec>\n\t  <jats:sec id=\"S2059866120004896_as2\">\n\t    <jats:title>Methods:<\/jats:title>\n\t    <jats:p>We performed a retrospective cohort study of 1023 COVID-19 patients diagnosed by RT-PCR at Stanford Hospital through April 8, 2020 with a minimum follow-up time of 14 days to investigate the association between ACE-I or ARB use with outcomes.<\/jats:p>\n\t  <\/jats:sec>\n\t  <jats:sec id=\"S2059866120004896_as3\">\n\t    <jats:title>Results:<\/jats:title>\n\t    <jats:p>Use of ACE-I or ARB medications was not associated with increased risk of hospitalization, intensive care unit admission, or death. Compared to patients with charted past medical history, there was a lower risk of hospitalization for patients on ACE-I (odds ratio (OR) 0.43; 95% confidence interval (CI) 0.19\u20130.97; <jats:italic>P<\/jats:italic> = 0.0426) and ARB (OR 0.39; 95% CI 0.17\u20130.90; <jats:italic>P<\/jats:italic> = 0.0270). Compared to patients with hypertension not on ACE-I or ARB, patients on ARB medications had a lower risk of hospitalization (OR 0.09; 95% CI 0.01\u20130.88; <jats:italic>P<\/jats:italic> = 0.0381).<\/jats:p>\n\t  <\/jats:sec>\n\t  <jats:sec id=\"S2059866120004896_as4\">\n\t    <jats:title>Conclusions:<\/jats:title>\n\t    <jats:p>These findings suggest that the use of ACE-I and ARB is not associated with adverse outcomes and may be associated with improved outcomes in COVID-19, which is immediately relevant to care of the many patients on these medications.<\/jats:p>\n\t  <\/jats:sec>","DOI":"10.1017\/cts.2020.489","type":"journal-article","created":{"date-parts":[[2020,6,1]],"date-time":"2020-06-01T08:18:35Z","timestamp":1590999515000},"source":"Crossref","is-referenced-by-count":6,"title":["Safety of ACE-I and ARB medications in COVID-19: A retrospective cohort study of inpatients and outpatients in California"],"prefix":"10.1017","volume":"5","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7335-3868","authenticated-orcid":false,"given":"Samuel J. 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Bozkurt, B , Kovacs, R , Harrington, B. HFSA\/ACC\/AHA Statement Addresses Concerns Re: Using RAAS Antagonists in COVID-19. American College of Cardiology [Internet], March 17, 2020 [cited April 26, 2020]. 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