{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,6]],"date-time":"2026-07-06T11:55:27Z","timestamp":1783338927334,"version":"3.54.6"},"reference-count":24,"publisher":"MDPI AG","issue":"12","license":[{"start":{"date-parts":[[2021,6,15]],"date-time":"2021-06-15T00:00:00Z","timestamp":1623715200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Sociedad Espa\u00f1ola de Medicina Interna","award":["None"],"award-info":[{"award-number":["None"]}]},{"DOI":"10.13039\/501100004587","name":"Instituto de Salud Carlos III","doi-asserted-by":"publisher","award":["CM19\/00149"],"award-info":[{"award-number":["CM19\/00149"]}],"id":[{"id":"10.13039\/501100004587","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Our main aim was to describe the effect on the severity of ACEI (angiotensin-converting enzyme inhibitor) and ARB (angiotensin II receptor blocker) during COVID-19 hospitalization. A retrospective, observational, multicenter study evaluating hospitalized patients with COVID-19 treated with ACEI\/ARB. The primary endpoint was the incidence of the composite outcome of prognosis (IMV (invasive mechanical ventilation), NIMV (non-invasive mechanical ventilation), ICU admission (intensive care unit), and\/or all-cause mortality). We evaluated both outcomes in patients whose treatment with ACEI\/ARB was continued or withdrawn. Between February and June 2020, 11,205 patients were included, mean age 67 years (SD = 16.3) and 43.1% female; 2162 patients received ACEI\/ARB treatment. ACEI\/ARB treatment showed lower all-cause mortality (p &lt; 0.0001). Hypertensive patients in the ACEI\/ARB group had better results in IMV, ICU admission, and the composite outcome of prognosis (p &lt; 0.0001 for all). No differences were found in the incidence of major adverse cardiovascular events. Patients previously treated with ACEI\/ARB continuing treatment during hospitalization had a lower incidence of the composite outcome of prognosis than those whose treatment was withdrawn (RR 0.67, 95%CI 0.63\u20130.76). ARB was associated with better survival than ACEI (HR 0.77, 95%CI 0.62\u20130.96). ACEI\/ARB treatment during COVID-19 hospitalization was associated with protection on mortality. The benefits were greater in hypertensive, those who continued treatment, and those taking ARB.<\/jats:p>","DOI":"10.3390\/jcm10122642","type":"journal-article","created":{"date-parts":[[2021,6,15]],"date-time":"2021-06-15T21:24:29Z","timestamp":1623792269000},"page":"2642","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Angiotensin-Converting Enzyme Inhibitors and Angiotensin Receptor Blockers Withdrawal Is Associated with Higher Mortality in Hospitalized Patients with COVID-19"],"prefix":"10.3390","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5253-5785","authenticated-orcid":false,"given":"Emilia","family":"Roy-Vallejo","sequence":"first","affiliation":[{"name":"Department of Internal Medicine, La Princesa University Hospital, Healthcare Research Institute-La Princesa Biomedical Research Foundation, 28006 Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aquilino","family":"S\u00e1nchez Purificaci\u00f3n","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, La Paz University Hospital, Hospital La Paz Institute for Health Research (IdiPAZ), Autonomous University of Madrid, 28046 Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jos\u00e9","family":"Torres Pe\u00f1a","sequence":"additional","affiliation":[{"name":"Lipids and Atherosclerosis Unit, Department of Internal Medicine, Maimonides Biomedical Research Institute of Cordoba (IMIBIC), Reina Sofia University Hospital, University of C\u00f3rdoba, 14004 C\u00f3rdoba, Spain"},{"name":"CIBER Physiopathology of Obesity and Nutrition (CIBEROBN), Carlos III Institute of Health, 28029 Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Beatriz","family":"S\u00e1nchez Moreno","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, La Princesa University Hospital, Healthcare Research Institute-La Princesa Biomedical Research Foundation, 28006 Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2943-0373","authenticated-orcid":false,"given":"Francisco","family":"Arnalich","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, La Paz University Hospital, Hospital La Paz Institute for Health Research (IdiPAZ), Autonomous University of Madrid, 28046 Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mar\u00eda","family":"Garc\u00eda Blanco","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, La Princesa University Hospital, Healthcare Research Institute-La Princesa Biomedical Research Foundation, 28006 Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8844-0718","authenticated-orcid":false,"given":"Jos\u00e9","family":"L\u00f3pez Miranda","sequence":"additional","affiliation":[{"name":"Lipids and Atherosclerosis Unit, Department of Internal Medicine, Maimonides Biomedical Research Institute of Cordoba (IMIBIC), Reina Sofia University Hospital, University of C\u00f3rdoba, 14004 C\u00f3rdoba, Spain"},{"name":"CIBER Physiopathology of Obesity and Nutrition (CIBEROBN), Carlos III Institute of Health, 28029 Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6459-3536","authenticated-orcid":false,"given":"Juan","family":"Romero-Cabrera","sequence":"additional","affiliation":[{"name":"Lipids and Atherosclerosis Unit, Department of Internal Medicine, Maimonides Biomedical Research Institute of Cordoba (IMIBIC), Reina Sofia University Hospital, University of C\u00f3rdoba, 14004 C\u00f3rdoba, Spain"},{"name":"CIBER Physiopathology of Obesity and Nutrition (CIBEROBN), Carlos III Institute of Health, 28029 Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carmen","family":"Herrero Gil","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, La Paz University Hospital, Hospital La Paz Institute for Health Research (IdiPAZ), Autonomous University of Madrid, 28046 Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jos\u00e9","family":"Bascunana","sequence":"additional","affiliation":[{"name":"Internal Medicine Department, 12 de Octubre University Hospital, 28041 Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9548-1374","authenticated-orcid":false,"given":"Manuel","family":"Rubio-Rivas","sequence":"additional","affiliation":[{"name":"Internal Medicine Department, Bellvitge University Hospital-IDIBELL, L\u2019Hospitalet de Llobregat, 08907 Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sara","family":"Pintos Otero","sequence":"additional","affiliation":[{"name":"Internal Medicine Department, Zamora Hospital Complex, 49022 Zamora, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ver\u00f3nica","family":"Mart\u00ednez Sempere","sequence":"additional","affiliation":[{"name":"Internal Medicine Department, San Juan de Alicante University Hospital, 03550 San Juan de Alicante, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jes\u00fas","family":"Ballano Rodr\u00edguez-Sol\u00eds","sequence":"additional","affiliation":[{"name":"Internal Medicine Department, Henares Hospital, 28822 Coslada, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ricardo","family":"Gil S\u00e1nchez","sequence":"additional","affiliation":[{"name":"Internal Medicine Department, La Fe University Hospital, 46026 Valencia, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jairo","family":"Luque del Pino","sequence":"additional","affiliation":[{"name":"Internal Medicine Department, Costa del Sol Hospital, 29603 Marbella, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amara","family":"Gonz\u00e1lez Noya","sequence":"additional","affiliation":[{"name":"Internal Medicine Department, Ourense University Hospital Complex, 32005 Ourense, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mar\u00eda","family":"Navas-Alc\u00e1ntara","sequence":"additional","affiliation":[{"name":"Internal Medicine Department, Infanta Margarita Hospital, 14940 Cabra, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0822-4917","authenticated-orcid":false,"given":"Bego\u00f1a","family":"Cort\u00e9s Rodr\u00edguez","sequence":"additional","affiliation":[{"name":"Internal Medicine Department, Alto Guadalquivir Hospital, 23740 And\u00fajar, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jos\u00e9","family":"Alcal\u00e1","sequence":"additional","affiliation":[{"name":"Internal Medicine Department, Pozoblanco Hospital, 14400 Pozoblanco, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ana","family":"Su\u00e1rez-Lombra\u00f1a","sequence":"additional","affiliation":[{"name":"Internal Medicine Department, Plat\u00f3n Hospital, 08006 Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1436-7239","authenticated-orcid":false,"given":"Jorge","family":"Andr\u00e9s Soler","sequence":"additional","affiliation":[{"name":"Internal Medicine Department, Castell\u00f3n University General Hospital, 12004 Castell\u00f3n de la Plana, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9909-3555","authenticated-orcid":false,"given":"Ricardo","family":"G\u00f3mez-Huelgas","sequence":"additional","affiliation":[{"name":"Internal Medicine Department, Regional University Hospital of M\u00e1laga, Biomedical Research Institute of M\u00e1laga (IBIMA), University of M\u00e1laga (UMA), 29010 M\u00e1laga, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jos\u00e9","family":"Casas-Rojo","sequence":"additional","affiliation":[{"name":"Internal Medicine Department, Infanta Cristina University Hospital, 28981 Parla, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jes\u00fas","family":"Mill\u00e1n N\u00fa\u00f1ez-Cort\u00e9s","sequence":"additional","affiliation":[{"name":"Internal Medicine Department, Gregorio Mara\u00f1\u00f3n University Hospital, 28007 Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"on behalf of the SEMI-COVID-19 Network","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2021,6,15]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"2441","DOI":"10.1056\/NEJMoa2008975","article-title":"Renin\u2013Angiotensin\u2013Aldosterone System Inhibitors and Risk of Covid-19","volume":"382","author":"Reynolds","year":"2020","journal-title":"N. 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Cardiol."}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/10\/12\/2642\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T06:16:36Z","timestamp":1760163396000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/10\/12\/2642"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,6,15]]},"references-count":24,"journal-issue":{"issue":"12","published-online":{"date-parts":[[2021,6]]}},"alternative-id":["jcm10122642"],"URL":"https:\/\/doi.org\/10.3390\/jcm10122642","relation":{"has-preprint":[{"id-type":"doi","id":"10.1101\/2021.02.24.21252391","asserted-by":"object"}]},"ISSN":["2077-0383"],"issn-type":[{"value":"2077-0383","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,6,15]]}}}