{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,3]],"date-time":"2025-08-03T04:21:08Z","timestamp":1754194868433,"version":"3.37.3"},"reference-count":35,"publisher":"BMJ","issue":"4","license":[{"start":{"date-parts":[[2020,12,8]],"date-time":"2020-12-08T00:00:00Z","timestamp":1607385600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/bmj.com\/coronavirus\/usage"}],"funder":[{"DOI":"10.13039\/501100006356","name":"University of Southern Denmark","doi-asserted-by":"crossref","award":["NA (see manuscript page 19)"],"award-info":[{"award-number":["NA (see manuscript page 19)"]}],"id":[{"id":"10.13039\/501100006356","id-type":"DOI","asserted-by":"crossref"}]},{"name":"Aarhus University","award":["NA (see manuscript page 19)"],"award-info":[{"award-number":["NA (see manuscript page 19)"]}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Thorax"],"published-print":{"date-parts":[[2021,4]]},"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>To examine the impact of ACE inhibitor (ACE-I)\/angiotensin receptor blocker (ARB) use on rate of SARS-CoV-2 infection and adverse outcomes.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This nationwide case-control and cohort study included all individuals in Denmark tested for SARS-CoV-2 RNA with PCR from 27 February 2020 to 26 July 2020. We estimated confounder-adjusted ORs for a positive test among all SARS-CoV-2 tested, and inverse probability of treatment weighted 30-day risk and risk ratios (RRs) of hospitalisation, intensive care unit (ICU) admission and mortality comparing current ACE-I\/ARB use with calcium channel blocker (CCB) use and with non-use.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The study included 13\u2009501 SARS-CoV-2 PCR-positive and 1 088 695 PCR-negative individuals. Users of ACE-I\/ARB had a marginally increased rate of a positive PCR when compared with CCB users (aOR 1.17, 95% CI 1.00 to 1.37), but not when compared with non-users (aOR 1.00 95% CI 0.92 to 1.09).<\/jats:p><jats:p>Among PCR-positive individuals, 1466 (11%) were ACE-I\/ARB users. The weighted risk of hospitalisation was 36.5% in ACE-I\/ARB users and 43.3% in CCB users (RR 0.84, 95% CI 0.70 to 1.02). The risk of ICU admission was 6.3% in ACE-I\/ARB users and 5.4% in CCB users (RR 1.17, 95% CI 0.64 to 2.16), while the 30-day mortality was 12.3% in ACE-I\/ARB users and 13.9% in CCB users (RR 0.89, 95% CI 0.61 to 1.30). The associations were similar when ACE-I\/ARB users were compared with non-users.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>ACE-I\/ARB use was associated neither with a consistently increased rate nor with adverse outcomes of SARS-CoV-2 infection. Our findings support the current recommendation of continuing use of ACE-Is\/ARBs during the SARS-CoV-2 pandemic.<\/jats:p><\/jats:sec><jats:sec><jats:title>Trial registration number<\/jats:title><jats:p>EUPAS34887<\/jats:p><\/jats:sec>","DOI":"10.1136\/thoraxjnl-2020-215768","type":"journal-article","created":{"date-parts":[[2020,12,8]],"date-time":"2020-12-08T15:07:37Z","timestamp":1607440057000},"page":"370-379","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":12,"title":["SARS-CoV-2 infection and adverse outcomes in users of ACE inhibitors and angiotensin-receptor blockers: a nationwide case-control and cohort analysis"],"prefix":"10.1136","volume":"76","clinical-trial-number":[{"clinical-trial-number":"nct04312009","registry":"10.18810\/clinical-trials-gov"},{"clinical-trial-number":"nct04328012","registry":"10.18810\/clinical-trials-gov"}],"author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0727-953X","authenticated-orcid":false,"given":"Christian Fynbo","family":"Christiansen","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anton","family":"Potteg\u00e5rd","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Uffe","family":"Heide-J\u00f8rgensen","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7398-814X","authenticated-orcid":false,"given":"Jacob","family":"Bodilsen","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ole Schmeltz","family":"S\u00f8gaard","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael","family":"Maeng","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Simon Tilma","family":"Vistisen","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Morten","family":"Schmidt","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lars Christian","family":"Lund","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1241-4385","authenticated-orcid":false,"given":"Mette","family":"Reilev","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jesper","family":"Hallas","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marianne","family":"Voldstedlund","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anders","family":"Husby","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marianne Kragh","family":"Thomsen","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nanna Borup","family":"Johansen","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nikolai Constantin","family":"Brun","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9135-3474","authenticated-orcid":false,"given":"Reimar Wernich","family":"Thomsen","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hans Erik","family":"B\u00f8tker","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Henrik Toft","family":"S\u00f8rensen","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2020,12,8]]},"reference":[{"key":"2021091702550599000_76.4.370.1","first-page":"1824","article-title":"Pharmacologic treatments for coronavirus disease 2019 (COVID-19): a review","volume":"323","author":"Sanders","year":"2020","journal-title":"JAMA"},{"key":"2021091702550599000_76.4.370.2","doi-asserted-by":"crossref","DOI":"10.1016\/S2213-2600(20)30116-8","article-title":"Are patients with hypertension and diabetes mellitus at increased risk for COVID-19 infection?","volume":"8","author":"Fang","year":"2020","journal-title":"Lancet Respir Med"},{"key":"2021091702550599000_76.4.370.3","doi-asserted-by":"crossref","unstructured":"Sommerstein R , Gr\u00e4ni C . 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