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Animal studies suggest that renin\u2013angiotensin\u2013aldosterone system (RAAS) blockers might increase the expression of ACE2 and potentially increase the risk of SARS\u2010CoV\u20102 infection.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods and Results<\/jats:title><jats:p>The effect of ACE inhibitor (ACEI) treatment on the pneumonia incidence in non\u2010COVID\u201019 patients (25 studies, 330\u2009780 patients) was associated with a 26% reduction of pneumonia risk (odds ratio [OR]: 0.74, <jats:italic>P<\/jats:italic>\u00a0&lt;\u00a0.001). Pneumonia\u2010related death cases in ACEI\u2010treated non\u2010COVID\u201019 patients were reduced by 27% (OR: 0.73, <jats:italic>P\u00a0=<\/jats:italic>\u00a0.004). However, angiotensin II receptor blockers (ARB) treatment (10 studies, 275\u2009621 non\u2010COVID\u201019 patients) did not alter pneumonia risk in patients. Pneumonia\u2010related death cases in ARB\u2010treated non\u2010COVID\u201019 patients was analysed only in 1 study and was significantly reduced (OR, 0.47; 95% confidence interval, 0.30 to 0.72). Results from 11 studies (8.4 million patients) showed that the risk of getting infected with the SARS\u2010CoV\u20102 virus was reduced by 13% (OR: 0.87, <jats:italic>P\u00a0=<\/jats:italic>\u00a0.014) in patients treated with ACEI, whereas analysis from 10 studies (8.4 million patients) treated with ARBs showed no effect (OR, 0.92, <jats:italic>P\u00a0=<\/jats:italic>\u00a0.354). Results from 34 studies in 67\u2009644 COVID\u201019 patients showed that RAAS blockade reduces all\u2010cause mortality by 24% (OR\u00a0=\u00a00.76, <jats:italic>P\u00a0=<\/jats:italic>\u00a0.04).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>ACEIs reduce the risk of getting infected with the SARS\u2010CoV\u20102 virus. Blocking the RAAS may decrease all\u2010cause mortality in COVID\u201019 patients. ACEIs also reduce the risk of non\u2010COVID pneumonia. All\u2010cause mortality due to non\u2010COVID pneumonia is reduced by ACEI and potentially by ARBs.<\/jats:p><\/jats:sec>","DOI":"10.1111\/bcp.14660","type":"journal-article","created":{"date-parts":[[2020,11,21]],"date-time":"2020-11-21T04:03:58Z","timestamp":1605931438000},"page":"2475-2492","source":"Crossref","is-referenced-by-count":26,"title":["Comparison of infection risks and clinical outcomes in patients with and without SARS\u2010CoV\u20102 lung infection under renin\u2013angiotensin\u2013aldosterone system blockade: Systematic review and meta\u2010analysis"],"prefix":"10.1111","volume":"87","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2018-4578","authenticated-orcid":false,"given":"Chang","family":"Chu","sequence":"first","affiliation":[{"name":"Fifth Department of Medicine (Nephrology\/Endocrinology\/Rheumatology) University Medical Centre Mannheim, University of Heidelberg  Germany"},{"name":"Department of Nephrology Charit\u00e9\u2010Universit\u00e4tsmedizin Berlin, Campus Mitte  Berlin Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shufei","family":"Zeng","sequence":"additional","affiliation":[{"name":"Fifth Department of Medicine (Nephrology\/Endocrinology\/Rheumatology) University Medical Centre Mannheim, University of Heidelberg  Germany"},{"name":"Department of Nephrology Charit\u00e9\u2010Universit\u00e4tsmedizin Berlin, Campus Mitte  Berlin Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0382-4916","authenticated-orcid":false,"given":"Ahmed A.","family":"Hasan","sequence":"additional","affiliation":[{"name":"Fifth Department of Medicine (Nephrology\/Endocrinology\/Rheumatology) University Medical Centre Mannheim, University of Heidelberg  Germany"},{"name":"Department of Nutritional Toxicology, Institute of Nutritional Science University of Potsdam  Nuthetal Germany"},{"name":"Department of Biochemistry, Faculty of Pharmacy Zagazig University  Egypt"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Carl\u2010Friedrich","family":"Hocher","sequence":"additional","affiliation":[{"name":"Fifth Department of Medicine (Nephrology\/Endocrinology\/Rheumatology) University Medical Centre Mannheim, University of Heidelberg  Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bernhard K.","family":"Kr\u00e4mer","sequence":"additional","affiliation":[{"name":"Fifth Department of Medicine (Nephrology\/Endocrinology\/Rheumatology) University Medical Centre Mannheim, University of Heidelberg  Germany"},{"name":"European Center of Angioscience, Medical Faculty Mannheim University of Heidelberg  Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8143-0579","authenticated-orcid":false,"given":"Berthold","family":"Hocher","sequence":"additional","affiliation":[{"name":"Fifth Department of Medicine (Nephrology\/Endocrinology\/Rheumatology) University Medical Centre Mannheim, University of Heidelberg  Germany"},{"name":"Key Laboratory of Study and Discovery of Small Targeted Molecules of Hunan Province, School of Medicine Hunan Normal University  Changsha China"},{"name":"Reproductive and Genetic Hospital of CITIC\u2010Xiangya  Changsha China"},{"name":"IMD Institut f\u00fcr Medizinische Diagnostik Berlin\u2010Potsdam GbR  Berlin Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2020,12,18]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41569-020-0360-5"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2213-2600(20)30116-8"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1001\/archinte.162.9.1059"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1093\/aje\/kwx105"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.39489.470347.AD"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1002\/sim.1188"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.e4260"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.327.7414.557"},{"issue":"1","key":"e_1_2_9_10_1","first-page":"95","article-title":"Czech and Slovak spirapril intervention study (CASSIS). 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