{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,29]],"date-time":"2026-06-29T15:19:47Z","timestamp":1782746387630,"version":"3.54.5"},"reference-count":40,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"13","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2021,7,6]]},"abstract":"<jats:sec xml:lang=\"en\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p xml:lang=\"en\">Despite its clinical significance, the risk of severe infection requiring hospitalization among outpatients with severe acute respiratory syndrome coronavirus 2 infection who receive angiotensin\u2010converting enzyme (ACE) inhibitors and angiotensin receptor blockers (ARBs) remains uncertain.<\/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                      In a propensity score\u2013matched outpatient cohort (January\u2013May 2020) of 2263 Medicare Advantage and commercially insured individuals with hypertension and a positive outpatient SARS\u2010CoV\u20102, we determined the association of ACE inhibitors and ARBs with COVID\u201019 hospitalization. In a concurrent inpatient cohort of 7933 hospitalized with COVID\u201019, we tested their association with in\u2010hospital mortality. The robustness of the observations was assessed in a contemporary cohort (May\u2013August). In the outpatient study, neither ACE inhibitors (hazard ratio [HR], 0.77; 0.53\u20131.13,\n                      <jats:italic>P<\/jats:italic>\n                      =0.18) nor ARBs (HR, 0.88; 0.61\u20131.26,\n                      <jats:italic>P<\/jats:italic>\n                      =0.48) were associated with hospitalization risk. ACE inhibitors were associated with lower hospitalization risk in the older Medicare group (HR, 0.61; 0.41\u20130.93,\n                      <jats:italic>P<\/jats:italic>\n                      =0.02), but not the younger commercially insured group (HR, 2.14; 0.82\u20135.60,\n                      <jats:italic>P<\/jats:italic>\n                      =0.12;\n                      <jats:italic>P<\/jats:italic>\n                      \u2010interaction 0.09). Neither ACE inhibitors nor ARBs were associated with lower hospitalization risk in either population in the validation cohort. In the primary inpatient study cohort, neither ACE inhibitors (HR, 0.97; 0.81\u20131.16;\n                      <jats:italic>P<\/jats:italic>\n                      =0.74) nor ARBs (HR, 1.15; 0.95\u20131.38,\n                      <jats:italic>P<\/jats:italic>\n                      =0.15) were associated with in\u2010hospital mortality. These observations were consistent in the validation cohort.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p xml:lang=\"en\">ACE inhibitors and ARBs were not associated with COVID\u201019 hospitalization or mortality. Despite early evidence for a potential association between ACE inhibitors and severe COVID\u201019 prevention in older individuals, the inconsistency of this observation in recent data argues against a role for prophylaxis.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1161\/jaha.120.018086","type":"journal-article","created":{"date-parts":[[2021,2,24]],"date-time":"2021-02-24T05:04:02Z","timestamp":1614143042000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":20,"title":["Association of Angiotensin\u2010Converting Enzyme Inhibitors and Angiotensin Receptor Blockers With the Risk of Hospitalization and Death in Hypertensive Patients With COVID\u201019"],"prefix":"10.1161","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9467-6199","authenticated-orcid":false,"given":"Rohan","family":"Khera","sequence":"first","affiliation":[{"name":"Section of Cardiovascular Medicine Department of Internal Medicine Yale School of Medicine New Haven CT"},{"name":"Center for Outcomes Research and Evaluation Yale\u2010New Haven Hospital New Haven CT"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Callahan","family":"Clark","sequence":"additional","affiliation":[{"name":"Research &amp; 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