{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,6]],"date-time":"2025-12-06T17:12:52Z","timestamp":1765041172109,"version":"3.37.3"},"reference-count":38,"publisher":"Oxford University Press (OUP)","issue":"1","license":[{"start":{"date-parts":[[2021,9,3]],"date-time":"2021-09-03T00:00:00Z","timestamp":1630627200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"name":"\u2018CIBER de Epidemiolog\u00eda y Salud P\u00fablica (CIBERESP)\u2019"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2022,1,12]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>The effect of renin\u2013angiotensin system (RAS) blockade either by angiotensin-converting enzyme inhibitors (ACEis) or angiotensin-receptor blockers (ARBs) on coronavirus disease 2019 (COVID-19) susceptibility, mortality and severity is inadequately described. We examined the association between RAS blockade and COVID-19 diagnosis and prognosis in a large population-based cohort of patients with hypertension (HTN).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This is a cohort study using regional health records. We identified all individuals aged 18\u201395 years from 87 healthcare reference areas of the main health provider in Catalonia (Spain), with a history of HTN from primary care records. Data were linked to COVID-19 test results, hospital, pharmacy and mortality records from 1 March 2020 to 14 August 2020. We defined exposure to RAS blockers as the dispensation of ACEi\/ARBs during the 3 months before COVID-19 diagnosis or 1 March 2020. Primary outcomes were: COVID-19 infection and severe progression in hospitalized patients with COVID-19 (the composite of need for invasive respiratory support or death). For both outcomes and for each exposure of interest (RAS blockade, ACEi or ARB) we estimated associations in age-, sex-, healthcare area- and propensity score-matched samples.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>From a cohort of 1 365 215 inhabitants we identified 305 972 patients with HTN history. Recent use of ACEi\/ARBs in patients with HTN was associated with a lower 6-month cumulative incidence of COVID-19 diagnosis {3.78% [95% confidence interval (CI) 3.69\u20133.86%] versus 4.53% (95% CI 4.40\u20134.65%); P &amp;lt; 0.001}. In the 12 344 patients with COVID-19 infection, the use of ACEi\/ARBs was not associated with a higher risk of hospitalization with need for invasive respiratory support or death [OR = 0.91 (0.71\u20131.15); P = 0.426].<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>RAS blockade in patients with HTN is not associated with higher risk of COVID-19 infection or with a worse progression of the disease.<\/jats:p><\/jats:sec>","DOI":"10.1093\/ckj\/sfab161","type":"journal-article","created":{"date-parts":[[2021,9,3]],"date-time":"2021-09-03T17:37:08Z","timestamp":1630690628000},"page":"79-94","source":"Crossref","is-referenced-by-count":5,"title":["Association of renin\u2013angiotensin system blockers with COVID-19 diagnosis and prognosis in patients with hypertension: a population-based study"],"prefix":"10.1093","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3621-0766","authenticated-orcid":false,"given":"Mar\u00eda Jos\u00e9","family":"Soler","sequence":"first","affiliation":[{"name":"Department of Nephrology, Vall d\u2019Hebron University Hospital, Universitat Aut\u00f2noma de Barcelona, Nephrology Research Group, Vall d\u2019Hebron Research Institute (VHIR), Barcelona, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Aida","family":"Ribera","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Cardiovascular Epidemiology Unit, Vall d\u2019Hebron University Hospital Vall d\u2019Hebron Research Institute (VHIR), Barcelona, Spain"},{"name":"Centro de Investigaci\u00f3n Biom\u00e9dica en Red de Epidemiolog\u00eda y Salud P\u00fablica (CIBERESP), Madrid, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Josep R","family":"Marsal","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Cardiovascular Epidemiology Unit, Vall d\u2019Hebron University Hospital Vall d\u2019Hebron Research Institute (VHIR), Barcelona, Spain"},{"name":"Centro de Investigaci\u00f3n Biom\u00e9dica en Red de Epidemiolog\u00eda y Salud P\u00fablica (CIBERESP), Madrid, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ana Belen","family":"Mendez","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Vall d\u2019Hebron University Hospital, Vall d\u2019Hebron Research Institute (VHIR), Barcelona, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mireia","family":"Andres","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Vall d\u2019Hebron University Hospital, Vall d\u2019Hebron Research Institute (VHIR), Barcelona, Spain"},{"name":"Centro de Investigaci\u00f3n Biom\u00e9dica en Red de Enfermedades Cardiovasculares (CIBERCV), Madrid, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maria Antonia","family":"Azancot","sequence":"additional","affiliation":[{"name":"Department of Nephrology, Vall d\u2019Hebron University Hospital, Universitat Aut\u00f2noma de Barcelona, Nephrology Research Group, Vall d\u2019Hebron Research Institute (VHIR), Barcelona, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gerard","family":"Oristrell","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Vall d\u2019Hebron University Hospital, Vall d\u2019Hebron Research Institute (VHIR), Barcelona, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Leonardo","family":"M\u00e9ndez-Boo","sequence":"additional","affiliation":[{"name":"Departament de Salut, SISAP: Sistema d\u2032Informaci\u00f3 dels Serveis d\u2032Atenci\u00f3 Prim\u00e0ria, Direcci\u00f3 de Sistemes d\u2032Informaci\u00f3, Institut Catal\u00e0 de la Salut, Generalitat de Catalunya, Barcelona, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jordana","family":"Cohen","sequence":"additional","affiliation":[{"name":"Division of Renal-Electrolyte and Hypertension, Center for Clinical Epidemiology and Biostatistics, Perelman School of Medicine, University of Pennsylvania, Pennsylvania, PA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jose A","family":"Barrab\u00e9s","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Vall d\u2019Hebron University Hospital, Vall d\u2019Hebron Research Institute (VHIR), Barcelona, Spain"},{"name":"Centro de Investigaci\u00f3n Biom\u00e9dica en Red de Enfermedades Cardiovasculares (CIBERCV), Madrid, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ignacio","family":"Ferreira-Gonz\u00e1lez","sequence":"additional","affiliation":[{"name":"Centro de Investigaci\u00f3n Biom\u00e9dica en Red de Epidemiolog\u00eda y Salud P\u00fablica (CIBERESP), Madrid, Spain"},{"name":"Department of Cardiology, Vall d\u2019Hebron University Hospital, Vall d\u2019Hebron Research Institute (VHIR), Barcelona, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"name":"Vall 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