{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,17]],"date-time":"2026-03-17T03:14:10Z","timestamp":1773717250335,"version":"3.50.1"},"reference-count":55,"publisher":"Oxford University Press (OUP)","issue":"5","license":[{"start":{"date-parts":[[2022,5,1]],"date-time":"2022-05-01T00:00:00Z","timestamp":1651363200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"funder":[{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["21605042"],"award-info":[{"award-number":["21605042"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2022,5,10]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>BACKGROUND<\/jats:title><jats:p>There is controversy over the effects of angiotensin-converting enzyme inhibitors (ACEIs) and angiotensin II receptor blockers (ARBs) on the prognosis in patients with coronavirus disease 2019 (COVID-19), therefore, we aim to further explore the effect of renin\u2013angiotensin\u2013aldosterone system inhibitors on COVID-19-associated disease severity and mortality.<\/jats:p><\/jats:sec><jats:sec><jats:title>METHODS<\/jats:title><jats:p>We systematically searched PubMed, Embase, Cochrane Library databases, medRxiv, and bioRxiv from inception to 6 September 2021. The primary outcome was all-cause mortality. Secondary outcome was severe disease which was defined as admission to the intensive care unit, the use of noninvasive or invasive mechanical ventilation, or death.<\/jats:p><\/jats:sec><jats:sec><jats:title>RESULTS<\/jats:title><jats:p>A total of 7 randomized controlled trials involving 1,321 COVID-19 patients were included. Fixed-effects meta-analysis demonstrated that the use of ACEI\/ARB was not associated with higher risk of mortality (risk ratio [RR] = 0.84, 95% confidence interval [CI] 0.57\u20131.22, P = 0.10, I2 = 43%) and disease severity (RR = 0.86, 95% CI 0.71\u20131.05, P = 0.11, I2 = 47%). However, the subgroup analysis showed that compared with no ACEI\/ARB use, the use of ARB was associated with a significant reduction of mortality (RR = 0.23, CI 0.09\u20130.60, P = 0.55, I2 = 0%) and disease severity (RR = 0.38, CI 0.19\u20130.77, P = 0.007).<\/jats:p><\/jats:sec><jats:sec><jats:title>CONCLUSIONS<\/jats:title><jats:p>In conclusion, based on the available data, ACEI\/ARB is not associated with the risk of mortality and disease severity in COVID-19 patients. And ACEI\/ARB medications, especially ARB, should not be discontinued for patients with COVID-19.<\/jats:p><\/jats:sec>","DOI":"10.1093\/ajh\/hpac001","type":"journal-article","created":{"date-parts":[[2022,1,4]],"date-time":"2022-01-04T20:09:02Z","timestamp":1641326942000},"page":"462-469","source":"Crossref","is-referenced-by-count":19,"title":["Effects of Renin\u2013Angiotensin System Inhibitors on Mortality and Disease Severity of COVID-19 Patients: A Meta-analysis of Randomized Controlled Trials"],"prefix":"10.1093","volume":"35","author":[{"given":"Juntao","family":"Yin","sequence":"first","affiliation":[{"name":"Department of Pharmacy, Huaihe Hospital, Henan University, Henan, China"},{"name":"Department of Pharmacology, Henan University of Chinese Medicine, Henan, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chaoyang","family":"Wang","sequence":"additional","affiliation":[{"name":"Translational Medicine Center, Huaihe Hospital, Henan University, Henan, 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