{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T07:29:00Z","timestamp":1782890940463,"version":"3.54.5"},"reference-count":26,"publisher":"Korean Society of Epidemiology","funder":[{"name":"Government-wide R&D Fund for Infectious Disease Research"},{"DOI":"10.13039\/501100003710","name":"Korea Health Industry Development Institute","doi-asserted-by":"publisher","award":["HG18C0068"],"award-info":[{"award-number":["HG18C0068"]}],"id":[{"id":"10.13039\/501100003710","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["e-epih.org"],"crossmark-restriction":true},"short-container-title":["Epidemiol Health"],"abstract":"<jats:p>OBJECTIVES: Recent evidence has shown no harm associated with the use of angiotensin-converting enzyme inhibitors (ACEIs) or angiotensin-receptor blockers (ARBs) in patients with coronavirus disease 2019 (COVID-19). We sought to further clarify the possible association between ACEI\/ARB use and the risk of poor clinical outcomes of COVID-19.METHODS: From the completely enumerated COVID-19 cohort in Korea, we identified 1,290 patients with hypertension, of whom 682 had and 603 did not have records of ACEI\/ARB use during the 30-day period before their COVID-19 diagnosis. Our primary endpoint comprised clinical outcomes, including all-cause mortality, use of mechanical ventilation, intensive care unit admission, and sepsis. We used inverse probability of treatment weighting (IPTW) to mitigate selection bias, and a Poisson regression model to estimate the relative risks (RRs) and 95% confidence intervals (CIs) for comparing outcomes between ACEI\/ARB users and non-users.RESULTS: Compared to non-use, ACEI\/ARB use was associated with lower clinical outcomes (IPTW-adjusted RR, 0.60; 95% CI, 0.42 to 0.85; p=0.005). For individual outcomes, ACEI\/ARB use was not associated with all-cause mortality (IPTW-adjusted RR, 0.62; 95% CI, 0.35 to 1.09; p=0.097) or respiratory events (IPTW-adjusted RR, 0.99; 95% CI, 0.84 to 1.17; p=0.904). Subgroup analysis showed a trend toward a protective role of ACEIs and ARBs against overall outcomes in men (IPTW-adjusted RR, 0.84; 95% CI, 0.69 to 1.03; p&lt;sub&gt;interaction&lt;\/sub&gt;=0.008) and patients with pre-existing respiratory disease (IPTW-adjusted RR, 0.74; 95% CI, 0.60 to 0.92; p&lt;sub&gt;interaction&lt;\/sub&gt;=0.002).CONCLUSIONS: We present clinical evidence to support continuing ACE\/ARB use in COVID-19 patients with hypertension based on the completely enumerated Korean cohort.<\/jats:p>","DOI":"10.4178\/epih.e2021004","type":"journal-article","created":{"date-parts":[[2020,12,28]],"date-time":"2020-12-28T21:14:01Z","timestamp":1609190041000},"page":"e2021004","update-policy":"https:\/\/doi.org\/10.4178\/crossmark_policy","source":"Crossref","is-referenced-by-count":11,"title":["Clinical outcomes of COVID-19 following the use of angiotensin-converting enzyme inhibitors or angiotensin-receptor blockers among patients with hypertension in Korea: a nationwide study"],"prefix":"10.4178","volume":"43","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7253-6515","authenticated-orcid":true,"given":"Ju Hwan","family":"Kim","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9597-6310","authenticated-orcid":true,"given":"Yeon-Hee","family":"Baek","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6556-9984","authenticated-orcid":true,"given":"Hyesung","family":"Lee","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2733-0715","authenticated-orcid":true,"given":"Young June","family":"Choe","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5781-0643","authenticated-orcid":true,"given":"Hyun Joon","family":"Shin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1010-7525","authenticated-orcid":true,"given":"Ju-Young","family":"Shin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"2679","published-online":{"date-parts":[[2020,12,29]]},"reference":[{"key":"ref1","volume-title":"WHO coronavirus disease (COVID-19) dashboard [cited 2020 Apr 27]"},{"key":"ref2","doi-asserted-by":"publisher","DOI":"10.1038\/s41569-020-0360-5"},{"key":"ref3","doi-asserted-by":"publisher","DOI":"10.1161\/circulationaha.104.510461"},{"key":"ref4","doi-asserted-by":"publisher","DOI":"10.1152\/ajpheart.01186.2004"},{"key":"ref5","doi-asserted-by":"publisher","DOI":"10.1161\/01.hyp.0000124667.34652.1a"},{"key":"ref6","doi-asserted-by":"publisher","DOI":"10.2174\/1389450117666160727142401"},{"key":"ref7","doi-asserted-by":"publisher","DOI":"10.1007\/s11906-013-0416-6"},{"key":"ref8","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.m1313"},{"key":"ref9","doi-asserted-by":"publisher","DOI":"10.1001\/jamacardio.2020.1624"},{"key":"ref10","doi-asserted-by":"publisher","DOI":"10.1080\/22221751.2020.1746200"},{"key":"ref11","doi-asserted-by":"publisher","DOI":"10.1056\/nejmoa2006923"},{"key":"ref12","doi-asserted-by":"publisher","DOI":"10.1056\/nejmoa2008975"},{"key":"ref13","first-page":"1671","volume-title":"Association of inpatient use of angiotensin-converting enzyme inhibitors and angiotensin II receptor blockers with mortality among patients with hypertension hospitalized with COVID-19","author":"Zhang","year":"2020"},{"key":"ref14","doi-asserted-by":"publisher","DOI":"10.3961\/jpmph.17.024"},{"key":"ref15","volume-title":"Laboratory testing for 2019 novel coronavirus (2019-nCoV) in suspected human cases: interim guidance","year":"2020"},{"key":"ref16","doi-asserted-by":"publisher","DOI":"10.1161\/circoutcomes.113.000359"},{"key":"ref17","doi-asserted-by":"publisher","DOI":"10.1016\/j.cell.2020.02.058"},{"key":"ref18","doi-asserted-by":"publisher","DOI":"10.1186\/s13054-017-1823-x"},{"key":"ref19","doi-asserted-by":"publisher","DOI":"10.1038\/nm1267"},{"key":"ref20","doi-asserted-by":"publisher","DOI":"10.1038\/nature03712"},{"key":"ref21","volume-title":"Position statement of the ESC Council on Hypertension on ACE-inhibitors and angiotensin receptor blockers [2020 Apr 9]"},{"key":"ref22","volume-title":"HFSA\/ACC\/AHA statement addresses concerns. Re: using RAAS antagonists in COVID-19","year":"2020"},{"key":"ref23","doi-asserted-by":"publisher","DOI":"10.1155\/2019\/4735876"},{"key":"ref24","volume-title":"Coronavirus disease-19, Republic of Korea [cited 2020 Apr 27]"},{"key":"ref25","first-page":"356","volume-title":"Screening for osteoporosis: U.S. preventive services task force recommendation statement","year":"2011"},{"key":"ref26","doi-asserted-by":"publisher","DOI":"10.1093\/aje\/kwg231"}],"container-title":["Epidemiology and Health"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/e-epih.org\/upload\/pdf\/epih-43-e2021004.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,8,23]],"date-time":"2022-08-23T22:02:21Z","timestamp":1661292141000},"score":1,"resource":{"primary":{"URL":"http:\/\/e-epih.org\/journal\/view.php?doi=10.4178\/epih.e2021004"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,12,29]]},"references-count":26,"URL":"https:\/\/doi.org\/10.4178\/epih.e2021004","relation":{"has-preprint":[{"id-type":"doi","id":"10.1101\/2020.07.29.20164822","asserted-by":"object"}]},"ISSN":["2092-7193"],"issn-type":[{"value":"2092-7193","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,12,29]]},"assertion":[{"value":"2020-09-02","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2020-12-28","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2020-12-29","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}