{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,27]],"date-time":"2026-09-27T00:54:20Z","timestamp":1790470460280,"version":"4.1.0"},"reference-count":19,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"22","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2020,11,17]]},"abstract":"<jats:sec xml:lang=\"en\">\n            <jats:title>Background<\/jats:title>\n            <jats:p xml:lang=\"en\">Severe acute respiratory syndrome coronavirus 2 (SARS\u2010CoV\u20102) utilizes the angiotensin\u2010converting enzyme\u20102 (ACE\u20102) receptor to enter human cells. Angiotensin\u2010converting enzyme inhibitors (ACEI) and angiotensin II receptor antagonists (ARB) are associated with ACE\u20102 upregulation. We hypothesized that antecedent use of ACEI\/ARB may be associated with mortality in coronavirus disease 2019 (COVID\u201019).<\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Methods and Results<\/jats:title>\n            <jats:p xml:lang=\"en\">\n              We used the Coracle registry, which contains data of patients hospitalized with COVID\u201019 in 4 regions of Italy, and restricted analyses to those \u226550\u00a0years of age. The primary outcome was in\u2010hospital mortality. Among these 781 patients, 133 (17.0%) used an ARB and 171 (21.9%) used an ACEI. While neither sex nor smoking status differed by user groups, patients on ACEI\/ARB were older and more likely to have hypertension, diabetes mellitus, and congestive heart failure. The overall mortality rate was 15.1% (118\/781) and increased with age (\n              <jats:italic>P<\/jats:italic>\n              <jats:sub>Trend<\/jats:sub>\n              &lt;0.0001). The crude odds ratios (ORs) for death for ACEI users and ARB users were 0.98, 95% CI, 0.60\u20131.60,\n              <jats:italic>P<\/jats:italic>\n              =0.9333, and 1.13, 95% CI, 0.67\u20131.91,\n              <jats:italic>P<\/jats:italic>\n              =0.6385, respectively. After adjusting for age, hypertension, diabetes mellitus, and congestive heart failure, antecedent ACEI administration was associated with reduced mortality (OR, 0.55; 95% CI, 0.31\u20130.98,\n              <jats:italic>P<\/jats:italic>\n              =0.0436); a similar, but weaker trend was observed for ARB administration (OR, 0.58; 95% CI, 0.32\u20131.07,\n              <jats:italic>P<\/jats:italic>\n              =0.0796).\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p xml:lang=\"en\">In those aged \u226550\u00a0years hospitalized with COVID\u201019, antecedent use of ACEI was independently associated with reduced risk of inpatient death. Our findings suggest a protective role of renin\u2010angiotensin\u2010aldosterone system inhibition in patients with high cardiovascular risk affected by COVID\u201019.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/jaha.120.017364","type":"journal-article","created":{"date-parts":[[2020,10,7]],"date-time":"2020-10-07T09:01:16Z","timestamp":1602061276000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":33,"title":["Antecedent Administration of Angiotensin\u2010Converting Enzyme Inhibitors or Angiotensin II Receptor Antagonists and Survival After Hospitalization for COVID\u201019 Syndrome"],"prefix":"10.1161","volume":"9","author":[{"given":"Alberto","family":"Palazzuoli","sequence":"first","affiliation":[{"name":"Cardiovascular Diseases Unit Department of Medical Sciences AOUS Le Scotte Hospital University of Siena 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G.","family":"Secco","sequence":"additional","affiliation":[{"name":"Interventional Cardiology and Cardiac Surgery Unit Azienda Ospedaliera SS Antonio e Biagio e Cesare Arrigo Alessandria Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gaetano M.","family":"Ruocco","sequence":"additional","affiliation":[{"name":"Cardiology Division Regina Montis Regalis Hospital Mondov\u00ec Cuneo Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3337-5293","authenticated-orcid":false,"given":"Fabrizio","family":"D'Ascenzo","sequence":"additional","affiliation":[{"name":"Cardiology Department of Medical Science, University of Turin Citt\u00e0 della Salute e Della Scienza Le Molinette Hospital Torino Torino 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Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2285-9970","authenticated-orcid":false,"given":"Francesco","family":"Blasi","sequence":"additional","affiliation":[{"name":"Respiratory Unit and Adult Cystic Fibrosis Center Department of Internal Medicine Fondazione IRCCS Ca\u2019 Granda Ospedale Maggiore Policlinico University of Milano Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2606-657X","authenticated-orcid":false,"given":"Fabio","family":"Infusino","sequence":"additional","affiliation":[{"name":"Department of Clinical Internal, Anesthesiological and Cardiovascular Sciences Sapienza, University of Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesco","family":"Fedele","sequence":"additional","affiliation":[{"name":"Department of Clinical Internal, Anesthesiological and Cardiovascular Sciences Sapienza, University of Rome 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