{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,5]],"date-time":"2026-03-05T21:23:38Z","timestamp":1772745818379,"version":"3.50.1"},"reference-count":26,"publisher":"Oxford University Press (OUP)","issue":"4","license":[{"start":{"date-parts":[[2020,10,13]],"date-time":"2020-10-13T00:00:00Z","timestamp":1602547200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"funder":[{"DOI":"10.13039\/100013384","name":"Kaiser Permanente Washington Health Research Institute","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100013384","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000050","name":"National Heart, Lung, and Blood Institute","doi-asserted-by":"publisher","award":["R01HL142599"],"award-info":[{"award-number":["R01HL142599"]}],"id":[{"id":"10.13039\/100000050","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2021,4,20]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Angiotensin-converting enzyme inhibitors (ACEIs) and angiotensin receptor blockers (ARBs) may increase the risk of coronavirus disease 2019 (COVID-19) infection or affect disease severity. Prior studies have not examined risks by medication dose.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This retrospective cohort study included people aged \u226518 years enrolled in a US integrated healthcare system for at least 4 months as of 2\/29\/2020. Current ACEI and ARB use was identified from pharmacy data, and the estimated daily dose was calculated and standardized across medications. COVID-19 infections and hospitalizations were identified through 6\/14\/2020 from laboratory and hospitalization data. We used logistic regression to estimate odds ratios (ORs) and 95% confidence intervals (CIs), adjusting for race\/ethnicity, obesity, and other covariates.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Among 322,044 individuals, 826 developed COVID-19 infection. Among people using ACEI\/ARBs, 204\/56,105 developed COVID-19 (3.6 per 1,000 individuals) compared with 622\/265,939 without ACEI\/ARB use (2.3 per 1,000), yielding an adjusted OR of 0.91 (95% CI 0.74\u20131.12). For use of &amp;lt;1 defined daily dose (DDD) vs. nonuse, the adjusted OR for infection was 0.92 (95% CI 0.66\u20131.28); for 1 to &amp;lt;2 DDDs, 0.89 (95% CI 0.66\u20131.19); and for \u22652 DDDs, 0.92 (95% CI 0.72\u20131.18). The OR was similar for ACEIs and ARBs and in subgroups by age and sex. 26% of people with COVID-19 infection were hospitalized; the adjusted OR for hospitalization in relation to ACEI\/ARB use was 0.98 (95% CI 0.63\u20131.54), and there was no association with dose.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>These findings support current recommendations that individuals on these medications continue their use.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/ajh\/hpaa168","type":"journal-article","created":{"date-parts":[[2020,10,7]],"date-time":"2020-10-07T07:42:06Z","timestamp":1602056526000},"page":"339-347","source":"Crossref","is-referenced-by-count":15,"title":["Renin\u2013Angiotensin\u2013Aldosterone System Inhibitors and COVID-19 Infection or Hospitalization: A Cohort Study"],"prefix":"10.1093","volume":"34","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6649-3659","authenticated-orcid":false,"given":"Sascha","family":"Dublin","sequence":"first","affiliation":[{"name":"Kaiser Permanente Washington Health Research Institute, Kaiser Permanente Washington , Seattle, Washington, USA"},{"name":"Department of Epidemiology, University of Washington , Seattle, Washington, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rod L","family":"Walker","sequence":"additional","affiliation":[{"name":"Kaiser Permanente Washington Health Research Institute, Kaiser Permanente Washington , Seattle, Washington, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"James S","family":"Floyd","sequence":"additional","affiliation":[{"name":"Kaiser Permanente Washington Health Research Institute, Kaiser Permanente Washington , Seattle, Washington, USA"},{"name":"Department of Epidemiology, University of Washington , Seattle, Washington, 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USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Laura B","family":"Harrington","sequence":"additional","affiliation":[{"name":"Kaiser Permanente Washington Health Research Institute, Kaiser Permanente Washington , Seattle, Washington, USA"},{"name":"Department of Epidemiology, University of Washington , Seattle, Washington, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mikael Anne","family":"Greenwood-Hickman","sequence":"additional","affiliation":[{"name":"Kaiser Permanente Washington Health Research Institute, Kaiser Permanente Washington , Seattle, Washington, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Beverly B","family":"Green","sequence":"additional","affiliation":[{"name":"Kaiser Permanente Washington Health Research Institute, Kaiser Permanente Washington , Seattle, Washington, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bruce 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