{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,6]],"date-time":"2025-12-06T09:09:06Z","timestamp":1765012146469,"version":"3.46.0"},"reference-count":29,"publisher":"BMJ","issue":"2","license":[{"start":{"date-parts":[[2021,2,16]],"date-time":"2021-02-16T00:00:00Z","timestamp":1613433600000},"content-version":"unspecified","delay-in-days":15,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2021,1,26]]},"published-print":{"date-parts":[[2021,2]]},"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Whether ACE inhibitors (ACEi) or angiotensin II receptor blocker (ARB) therapy should be continued, initiated or ceased in patients with COVID-19 is uncertain. Given the widespread use of ACEi\/ARBs worldwide, guidance on the use of these drugs is urgently needed. This prospective meta-analysis aims to pool data from randomised controlled trials (RCTs) to assess the safety and efficacy of ACEi\/ARB therapy in adults infected with SARS-CoV-2.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and analysis<\/jats:title>\n                    <jats:p>RCTs will be eligible if they compare patients with COVID-19 randomised to ACEi\/ARB continuation or commencement versuss no ACEi\/ARB therapy; study duration \u226514 days; recruitment completed between March 2020 and May 2021. The primary outcome will be all-cause mortality at \u226430 days. Secondary outcomes will include mechanical ventilation, admission to intensive care or cardiovascular events at short-term follow-up (\u226430 days) and all-cause mortality at longer-term follow-up (&gt;1\u2009month). Prespecified subgroup analyses will assess the effect of sex; age; comorbidities; smoking status; ethnicity; country of origin on all-cause mortality. A search of ClinicalTrials.gov has been performed, which will be followed by a formal search of trial registers, preprint servers, MEDLINE, EMBASE and Cochrane Central Register of Controlled Trials to identify RCTs that meet inclusion criteria. To date, a search of ClinicalTrials.gov identified 21 potentially eligible trials for this meta-analysis. We will request trial investigators\/sponsors to contribute standardised grouped tabular outcome data.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Ethics and dissemination<\/jats:title>\n                    <jats:p>Ethics approval and informed consent will be the responsibility of the individual RCTs. Dissemination of results will occur by peer-reviewed publication. The results of our analysis can inform public health policy and clinical decision making regarding ACEi\/ARB use in patients with COVID-19 on a global scale.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2020-043625","type":"journal-article","created":{"date-parts":[[2021,2,17]],"date-time":"2021-02-17T04:38:49Z","timestamp":1613536729000},"page":"e043625","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":10,"title":["Prospective meta-analysis protocol on randomised trials of renin\u2013angiotensin system inhibitors in patients with COVID-19: an initiative of the International Society of Hypertension"],"prefix":"10.1136","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4145-6461","authenticated-orcid":false,"given":"Sonali Rukshana","family":"Gnanenthiran","sequence":"first","affiliation":[{"name":"The George Institute for Global Health; University of New South Wales, Sydney, New South Wales, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Claudio","family":"Borghi","sequence":"additional","affiliation":[{"name":"Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dylan","family":"Burger","sequence":"additional","affiliation":[{"name":"Department of Cellular and Molecular Medicine, Kidney Research Centre, Ottawa Hospital Research Institute, University of Ottawa, Ottawa, Ontario, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fadi","family":"Charchar","sequence":"additional","affiliation":[{"name":"School of Health and Life Sciences, Federation University Australia, Ballarat, Victoria, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Neil R","family":"Poulter","sequence":"additional","affiliation":[{"name":"Imperial Clinical Trials Unit, Imperial College London, London, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Markus P","family":"Schlaich","sequence":"additional","affiliation":[{"name":"Dobney Hypertension Centre, School of Medicine, Royal Perth Hospital Unit, University of Western Australia, Perth, Western Australia, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ulrike Muscha","family":"Steckelings","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular and Renal Research, University of Southern Denmark, Odense, Denmark"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"George","family":"Stergiou","sequence":"additional","affiliation":[{"name":"Third Department of Medicine, Hypertension Center STRIDE-7, School of Medicine, Sotiria Hospital, National and Kapodistrian University of Athens, Athens, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maciej","family":"Tomaszewski","sequence":"additional","affiliation":[{"name":"Division of Medicine and Manchester Academic Health Science Centre, Manchester University NHS Foundation Trust Manchester, Manchester, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Thomas","family":"Unger","sequence":"additional","affiliation":[{"name":"CARIM\u2013School for Cardiovascular Diseases, Maastricht University, Maastricht, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Richard D","family":"Wainford","sequence":"additional","affiliation":[{"name":"Department of Pharmacology and Experimental Therapeutics and the Whitaker Cardiovascular Institute, Boston University School of Medicine, Boston, Massachusetts, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8094-1841","authenticated-orcid":false,"given":"Bryan","family":"Williams","sequence":"additional","affiliation":[{"name":"Institute of Cardiovascular Science, University College London and National Institute for Health Research (NIHR) University College London Hospitals Biomedical Research Centre, London, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anthony","family":"Rodgers","sequence":"additional","affiliation":[{"name":"The George Institute for Global Health; 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