{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,16]],"date-time":"2026-01-16T07:19:08Z","timestamp":1768547948067,"version":"3.49.0"},"reference-count":108,"publisher":"Elsevier BV","license":[{"start":{"date-parts":[[2021,1,1]],"date-time":"2021-01-01T00:00:00Z","timestamp":1609459200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"},{"start":{"date-parts":[[2021,1,1]],"date-time":"2021-01-01T00:00:00Z","timestamp":1609459200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/legal\/tdmrep-license"},{"start":{"date-parts":[[2021,4,9]],"date-time":"2021-04-09T00:00:00Z","timestamp":1617926400000},"content-version":"vor","delay-in-days":98,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["elsevier.com","sciencedirect.com"],"crossmark-restriction":true},"short-container-title":["Clinics"],"published-print":{"date-parts":[[2021]]},"DOI":"10.6061\/clinics\/2021\/e2342","type":"journal-article","created":{"date-parts":[[2021,4,7]],"date-time":"2021-04-07T09:51:49Z","timestamp":1617789109000},"page":"e2342","update-policy":"https:\/\/doi.org\/10.1016\/elsevier_cm_policy","source":"Crossref","is-referenced-by-count":8,"special_numbering":"C","title":["Renin-Angiotensin-Aldosterone System Inhibitors in COVID-19: A Review"],"prefix":"10.1016","volume":"76","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6929-8392","authenticated-orcid":false,"given":"Filipe","family":"Ferrari","sequence":"first","affiliation":[]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1483-4335","authenticated-orcid":false,"given":"V\u00edtor Magnus","family":"Martins","sequence":"additional","affiliation":[]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1191-0523","authenticated-orcid":false,"given":"Fl\u00e1vio Danni","family":"Fuchs","sequence":"additional","affiliation":[]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2357-5176","authenticated-orcid":false,"given":"Ricardo","family":"Stein","sequence":"additional","affiliation":[]}],"member":"78","reference":[{"issue":"4","key":"10.6061\/clinics\/2021\/e2342_bib1","doi-asserted-by":"crossref","first-page":"e21","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"},{"issue":"7","key":"10.6061\/clinics\/2021\/e2342_bib2","doi-asserted-by":"crossref","first-page":"825","DOI":"10.1001\/jamacardio.2020.1624","article-title":"Association of Renin-Angiotensin System Inhibitors With Severity or Risk of Death in Patients With Hypertension Hospitalized for Coronavirus Disease 2019 (COVID-19) Infection in Wuhan, China","volume":"5","author":"Li","year":"2020","journal-title":"JAMA Cardiol"},{"issue":"2","key":"10.6061\/clinics\/2021\/e2342_bib3","doi-asserted-by":"crossref","first-page":"854","DOI":"10.1002\/jmv.26315","article-title":"Efficacy of ACEIs\/ARBs vs CCBs on the progression of COVID-19 patients with hypertension in Wuhan: A hospital-based retrospective cohort study","volume":"93","author":"Liu","year":"2021","journal-title":"J Med Virol"},{"key":"10.6061\/clinics\/2021\/e2342_bib4","article-title":"A Retrospective Study from 2 Centers in China on the Effects of Continued Use of Angiotensin-Converting Enzyme Inhibitors and Angiotensin II Receptor Blockers in Patients with Hypertension and COVID-19","volume":"26","author":"Wang","year":"2020","journal-title":"Med Sci Monit"},{"issue":"1","key":"10.6061\/clinics\/2021\/e2342_bib5","doi-asserted-by":"crossref","first-page":"51","DOI":"10.1161\/HYPERTENSIONAHA.120.15143","article-title":"Effects of Angiotensin II Receptor Blockers and ACE (Angiotensin-Converting Enzyme) Inhibitors on Virus Infection, Inflammatory Status, and Clinical Outcomes in Patients With COVID-19 and Hypertension: A Single-Center Retrospective Study","volume":"76","author":"Yang","year":"2020","journal-title":"Hypertension"},{"issue":"7","key":"10.6061\/clinics\/2021\/e2342_bib6","doi-asserted-by":"crossref","first-page":"430","DOI":"10.21037\/atm.2020.03.229","article-title":"The effect of RAS blockers on the clinical characteristics of COVID-19 patients with hypertension","volume":"8","author":"Huang","year":"2020","journal-title":"Ann Transl Med"},{"issue":"2","key":"10.6061\/clinics\/2021\/e2342_bib7","doi-asserted-by":"crossref","first-page":"e10","DOI":"10.1161\/HYPERTENSIONAHA.120.15312","article-title":"Renin-Angiotensin-Aldosterone System Inhibitors and Outcome in Patients With SARS-CoV-2 Pneumonia: A Case Series Study","volume":"76","author":"Conversano","year":"2020","journal-title":"Hypertension"},{"issue":"12","key":"10.6061\/clinics\/2021\/e2342_bib8","doi-asserted-by":"crossref","first-page":"1483","DOI":"10.1111\/imj.15078","article-title":"Angiotensin-converting enzyme inhibitors or angiotensin II receptor blockers and prognosis of hypertensive patients hospitalised with COVID-19","volume":"50","author":"Covino","year":"2020","journal-title":"Intern Med J"},{"key":"10.6061\/clinics\/2021\/e2342_bib9","article-title":"RAAS inhibitors are not associated with mortality in COVID-19 patients: Findings from an observational multicenter study in Italy and a meta-analysis of 19 studies","volume":"135","year":"2020","journal-title":"Vascul Pharmacol"},{"issue":"25","key":"10.6061\/clinics\/2021\/e2342_bib10","doi-asserted-by":"crossref","first-page":"2431","DOI":"10.1056\/NEJMoa2006923","article-title":"Renin-Angiotensin-Aldosterone System Blockers and the Risk of Covid-19","volume":"382","author":"Mancia","year":"2020","journal-title":"N Engl J Med"},{"issue":"17","key":"10.6061\/clinics\/2021\/e2342_bib11","doi-asserted-by":"crossref","DOI":"10.1161\/JAHA.120.016948","article-title":"Could Anti-Hypertensive Drug Therapy Affect the Clinical Prognosis of Hypertensive Patients With COVID-19 Infection? Data From Centers of Southern Italy","volume":"9","author":"Sardu","year":"2020","journal-title":"J Am Heart Assoc"},{"issue":"9","key":"10.6061\/clinics\/2021\/e2342_bib12","article-title":"The Association of Renin-Angiotensin-Aldosterone System Inhibitors With Outcomes Among a Predominantly Ethnic Minority Patient Population Hospitalized With COVID-19: The Bronx Experience","volume":"12","author":"Adrish","year":"2020","journal-title":"Cureus"},{"issue":"8","key":"10.6061\/clinics\/2021\/e2342_bib13","doi-asserted-by":"crossref","first-page":"1256","DOI":"10.1093\/infdis\/jiaa447","article-title":"Continued In-Hospital Angiotensin-Converting Enzyme Inhibitor and Angiotensin II Receptor Blocker Use in Hypertensive COVID-19 Patients Is Associated With Positive Clinical Outcome","volume":"222","author":"Lam","year":"2020","journal-title":"J Infect Dis"},{"issue":"25","key":"10.6061\/clinics\/2021\/e2342_bib14","doi-asserted-by":"crossref","first-page":"2441","DOI":"10.1056\/NEJMoa2008975","article-title":"Renin-Angiotensin-Aldosterone System Inhibitors and Risk of Covid-19","volume":"382","author":"Reynolds","year":"2020","journal-title":"N Engl J Med"},{"issue":"11","key":"10.6061\/clinics\/2021\/e2342_bib15","doi-asserted-by":"crossref","DOI":"10.1093\/ofid\/ofaa519","article-title":"Effects of Recent Use of Renin-Angiotensin System Inhibitors on Mortality of Patients With Coronavirus Disease 2019","volume":"7","author":"Bae","year":"2020","journal-title":"Open Forum Infect Dis"},{"key":"10.6061\/clinics\/2021\/e2342_bib16","article-title":"Update on association between exposure to renin-angiotensin-aldosterone system inhibitors and coronavirus disease 2019 in South Korea","author":"Seo","year":"2020","journal-title":"Korean J Intern Med"},{"issue":"16","key":"10.6061\/clinics\/2021\/e2342_bib17","doi-asserted-by":"crossref","first-page":"2121","DOI":"10.1093\/cid\/ciaa624","article-title":"Association of Renin-angiotensin-aldosterone System Inhibitors With Coronavirus Disease 2019 (COVID-19)- Related Outcomes in Korea: A Nationwide Population-based Cohort Study","volume":"71","author":"Jung","year":"2020","journal-title":"Clin Infect Dis"},{"issue":"25","key":"10.6061\/clinics\/2021\/e2342_bib18","doi-asserted-by":"crossref","first-page":"e232","DOI":"10.3346\/jkms.2020.35.e232","article-title":"Compliance of Antihypertensive Medication and Risk of Coronavirus Disease 2019: a Cohort Study Using Big Data from the Korean National Health Insurance Service","volume":"35","author":"Kim","year":"2020","journal-title":"J Korean Med Sci"},{"issue":"3","key":"10.6061\/clinics\/2021\/e2342_bib19","doi-asserted-by":"crossref","first-page":"742","DOI":"10.1161\/HYPERTENSIONAHA.120.15464","article-title":"Association Between Renin-Angiotensin-Aldosterone System Inhibitors and COVID-19 Infection in South Korea","volume":"76","author":"Son","year":"2020","journal-title":"Hypertension"},{"key":"10.6061\/clinics\/2021\/e2342_bib20","article-title":"Association of Angiotensin-Converting Enzyme Inhibitors and Angiotensin II Blockers With Severity of COVID-19: A Multicenter, Prospective Study","author":"Hakeam","year":"2020","journal-title":"J Cardiovasc Pharmacol Ther"},{"key":"10.6061\/clinics\/2021\/e2342_bib21","article-title":"Association between renin-angiotensin-aldosterone system inhibitor use and COVID-19 hospitalization and death: A 1.4 million patient nationwide registry analysis","author":"Savarese","year":"2020","journal-title":"Eur J Heart Fail"},{"key":"10.6061\/clinics\/2021\/e2342_bib22","doi-asserted-by":"crossref","DOI":"10.1111\/jch.13948","article-title":"Use of distinct anti-hypertensive drugs and risk for COVID-19 among hypertensive people: A population-based cohort study in Southern Catalonia, Spain","author":"Vila-Corcoles","year":"2020","journal-title":"J Clin Hypertens (Greenwich)"},{"key":"10.6061\/clinics\/2021\/e2342_bib23","first-page":"10.1111","article-title":"ACE inhibitors, angiotensin receptor blockers and endothelial injury in COVID-19","author":"Tetlow","year":"2020","journal-title":"J Intern Med"},{"issue":"4","key":"10.6061\/clinics\/2021\/e2342_bib24","doi-asserted-by":"crossref","first-page":"149","DOI":"10.1177\/0036933020951926","article-title":"Angiotensin converting enzyme inhibitors do not increase the risk of poor outcomes in COVID-19 disease. A multi-centre observational study","volume":"65","author":"Khan","year":"2020","journal-title":"Scott Med J"},{"issue":"Suppl 2","key":"10.6061\/clinics\/2021\/e2342_bib25","doi-asserted-by":"crossref","first-page":"71","DOI":"10.1590\/1806-9282.66.s2.71","article-title":"Impact of antihypertensive agents on clinical course and in-hospital mortality: analysis of 169 hypertensive patients hospitalized for COVID-19","volume":"66","author":"Kocayigit","year":"2020","journal-title":"Rev Assoc Med Bras (1992)"},{"issue":"1","key":"10.6061\/clinics\/2021\/e2342_bib26","first-page":"21","article-title":"Association between chronic ACE inhibitor exposure and decreased odds of severe disease in patients with COVID-19","volume":"24","author":"\u015eenkal","year":"2020","journal-title":"Anatol J Cardiol"},{"issue":"2","key":"10.6061\/clinics\/2021\/e2342_bib27","doi-asserted-by":"crossref","first-page":"168","DOI":"10.1001\/jama.2020.11301","article-title":"Association of Angiotensin-Converting Enzyme Inhibitor or Angiotensin Receptor Blocker Use With COVID-19 Diagnosis and Mortality","volume":"324","author":"Fosb\u00f8l","year":"2020","journal-title":"JAMA"},{"key":"10.6061\/clinics\/2021\/e2342_bib28","author":"American College of Cardiology"},{"issue":"8","key":"10.6061\/clinics\/2021\/e2342_bib29","article-title":"Angiotensin converting enzyme (ACE) inhibitors versus angiotensin receptor blockers for primary hypertension","volume":"2014","author":"Li","year":"2014","journal-title":"Cochrane Database Syst Rev"},{"issue":"2","key":"10.6061\/clinics\/2021\/e2342_bib30","doi-asserted-by":"crossref","first-page":"373","DOI":"10.1016\/S0025-7125(02)00174-8","article-title":"ACE inhibitors and ARBs in chronic heart failure: the established, the expected, and the pragmatic","volume":"87","author":"Poole-Wilson","year":"2003","journal-title":"Med Clin North Am"},{"issue":"12","key":"10.6061\/clinics\/2021\/e2342_bib31","doi-asserted-by":"crossref","first-page":"1242","DOI":"10.1111\/j.1525-1497.2006.00590.x","article-title":"Angiotensin inhibition after myocardial infarction: does drug class matter?","volume":"21","author":"Winkelmayer","year":"2006","journal-title":"J Gen Intern Med"},{"issue":"6","key":"10.6061\/clinics\/2021\/e2342_bib32","doi-asserted-by":"crossref","first-page":"967","DOI":"10.1002\/ejhf.1924","article-title":"Angiotensin-converting enzyme inhibitors and angiotensin II receptor blockers are not associated with severe COVID-19 infection in a multi-site UK acute hospital trust","volume":"22","author":"Bean","year":"2020","journal-title":"Eur J Heart Fail"},{"issue":"6","key":"10.6061\/clinics\/2021\/e2342_bib33","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0235248","article-title":"Predictors of severe or lethal COVID-19, including Angiotensin Converting Enzyme inhibitors and Angiotensin II Receptor Blockers, in a sample of infected Italian citizens","volume":"15","author":"Bravi","year":"2020","journal-title":"PLoS One"},{"issue":"6","key":"10.6061\/clinics\/2021\/e2342_bib34","doi-asserted-by":"crossref","first-page":"412","DOI":"10.1093\/ehjcvp\/pvaa056","article-title":"Continuation versus discontinuation of ACE inhibitors or angiotensin II receptor blockers in COVID-19: effects on blood pressure control and mortality","volume":"6","author":"Cannata","year":"2020","journal-title":"Eur Heart J Cardiovasc Pharmacother"},{"issue":"10238","key":"10.6061\/clinics\/2021\/e2342_bib35","doi-asserted-by":"crossref","first-page":"1705","DOI":"10.1016\/S0140-6736(20)31030-8","article-title":"Use of renin-angiotensin-aldosterone system inhibitors and risk of COVID-19 requiring admission to hospital: a case-population study","volume":"395","author":"de Abajo","year":"2020","journal-title":"Lancet"},{"issue":"7","key":"10.6061\/clinics\/2021\/e2342_bib36","doi-asserted-by":"crossref","first-page":"909","DOI":"10.1016\/j.jamda.2020.06.018","article-title":"The Effects of ARBs, ACEis, and Statins on Clinical Outcomes of COVID-19 Infection Among Nursing Home Residents","volume":"21","author":"De Spiegeleer","year":"2020","journal-title":"J Am Med Dir Assoc"},{"issue":"10","key":"10.6061\/clinics\/2021\/e2342_bib37","doi-asserted-by":"crossref","first-page":"944","DOI":"10.1093\/ajh\/hpaa096","article-title":"Use of RAAS Inhibitors and Risk of Clinical Deterioration in COVID-19: Results From an Italian Cohort of 133 Hypertensives","volume":"33","author":"Felice","year":"2020","journal-title":"Am J Hypertens"},{"issue":"22","key":"10.6061\/clinics\/2021\/e2342_bib38","doi-asserted-by":"crossref","first-page":"2058","DOI":"10.1093\/eurheartj\/ehaa433","article-title":"Association of hypertension and antihypertensive treatment with COVID-19 mortality: a retrospective observational study","volume":"41","author":"Gao","year":"2020","journal-title":"Eur Heart J"},{"issue":"19","key":"10.6061\/clinics\/2021\/e2342_bib39","doi-asserted-by":"crossref","first-page":"1503","DOI":"10.1136\/heartjnl-2020-317393","article-title":"Risk of severe COVID-19 disease with ACE inhibitors and angiotensin receptor blockers: cohort study including 8.3 million people","volume":"106","author":"Hippisley-Cox","year":"2020","journal-title":"Heart"},{"issue":"9","key":"10.6061\/clinics\/2021\/e2342_bib40","doi-asserted-by":"crossref","first-page":"1020","DOI":"10.1001\/jamacardio.2020.1855","article-title":"Association of Use of Angiotensin-Converting Enzyme Inhibitors and Angiotensin II Receptor Blockers With Testing Positive for Coronavirus Disease 2019 (COVID-19)","volume":"5","author":"Mehta","year":"2020","journal-title":"JAMA Cardiol"},{"issue":"3","key":"10.6061\/clinics\/2021\/e2342_bib41","doi-asserted-by":"crossref","first-page":"732","DOI":"10.1161\/HYPERTENSIONAHA.120.15289","article-title":"Clinical Features of COVID-19 in Patients With Essential Hypertension and the Impacts of Renin-angiotensin-aldosterone System Inhibitors on the Prognosis of COVID-19 Patients","volume":"76","author":"Pan","year":"2020","journal-title":"Hypertension"},{"issue":"5","key":"10.6061\/clinics\/2021\/e2342_bib42","doi-asserted-by":"crossref","first-page":"601","DOI":"10.1007\/s11684-020-0800-y","article-title":"Use of angiotensin-converting enzyme inhibitors and angiotensin II receptor blockers in context of COVID-19 outbreak: a retrospective analysis","volume":"14","author":"Xu","year":"2020","journal-title":"Front Med"},{"issue":"12","key":"10.6061\/clinics\/2021\/e2342_bib43","doi-asserted-by":"crossref","first-page":"1671","DOI":"10.1161\/CIRCRESAHA.120.317134","article-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","volume":"126","author":"Zhang","year":"2020","journal-title":"Circ Res"},{"issue":"2","key":"10.6061\/clinics\/2021\/e2342_bib44","doi-asserted-by":"crossref","first-page":"e15","DOI":"10.1161\/HYPERTENSIONAHA.120.15622","article-title":"Comparative Impacts of ACE (Angiotensin-Converting Enzyme) Inhibitors Versus Angiotensin II Receptor Blockers on the Risk of COVID-19 Mortality","volume":"76","author":"Zhou","year":"2020","journal-title":"Hypertension"},{"issue":"5","key":"10.6061\/clinics\/2021\/e2342_bib45","doi-asserted-by":"crossref","first-page":"2620","DOI":"10.1172\/JCI137244","article-title":"Clinical and immunological features of severe and moderate coronavirus disease 2019","volume":"130","author":"Chen","year":"2020","journal-title":"J Clin Invest"},{"issue":"11","key":"10.6061\/clinics\/2021\/e2342_bib46","doi-asserted-by":"crossref","first-page":"1061","DOI":"10.1001\/jama.2020.1585","article-title":"Clinical Characteristics of 138 Hospitalized Patients With 2019 Novel Coronavirus-Infected Pneumonia in Wuhan, China","volume":"323","author":"Wang","year":"2020","journal-title":"JAMA"},{"issue":"18","key":"10.6061\/clinics\/2021\/e2342_bib47","doi-asserted-by":"crossref","first-page":"1708","DOI":"10.1056\/NEJMoa2002032","article-title":"Clinical Characteristics of Coronavirus Disease 2019 in China","volume":"382","author":"Guan","year":"2020","journal-title":"N Engl J Med"},{"issue":"7","key":"10.6061\/clinics\/2021\/e2342_bib48","doi-asserted-by":"crossref","first-page":"819","DOI":"10.1001\/jamacardio.2020.1096","article-title":"Cardiac Involvement in a Patient With Coronavirus Disease 2019 (COVID-19)","volume":"5","author":"Inciardi","year":"2020","journal-title":"JAMA Cardiol"},{"issue":"19","key":"10.6061\/clinics\/2021\/e2342_bib49","doi-asserted-by":"crossref","first-page":"1787","DOI":"10.1056\/NEJMoa2001282","article-title":"A Trial of Lopinavir-Ritonavir in Adults Hospitalized with Severe Covid-19","volume":"382","author":"Cao","year":"2020","journal-title":"N Engl J Med"},{"issue":"1","key":"10.6061\/clinics\/2021\/e2342_bib50","doi-asserted-by":"crossref","DOI":"10.7189\/jogh.10.011004","article-title":"Epidemiological analysis of the early 38 fatalities in Hubei, China, of the coronavirus disease 2019","volume":"10","author":"Chen","year":"2020","journal-title":"J Glob Health"},{"issue":"10223","key":"10.6061\/clinics\/2021\/e2342_bib51","doi-asserted-by":"crossref","first-page":"507","DOI":"10.1016\/S0140-6736(20)30211-7","article-title":"Epidemiological and clinical characteristics of 99 cases of 2019 novel coronavirus pneumonia in Wuhan, China: a descriptive study","volume":"395","author":"Chen","year":"2020","journal-title":"Lancet"},{"issue":"7","key":"10.6061\/clinics\/2021\/e2342_bib52","doi-asserted-by":"crossref","first-page":"811","DOI":"10.1001\/jamacardio.2020.1017","article-title":"Cardiovascular Implications of Fatal Outcomes of Patients With Coronavirus Disease 2019 (COVID-19)","volume":"5","author":"Guo","year":"2020","journal-title":"JAMA Cardiol"},{"issue":"7","key":"10.6061\/clinics\/2021\/e2342_bib53","doi-asserted-by":"crossref","first-page":"498","DOI":"10.1080\/23744235.2020.1759817","article-title":"Risk factors for disease progression in hospitalized patients with COVID-19: a retrospective cohort study","volume":"52","author":"Hou","year":"2020","journal-title":"Infect Dis (Lond)"},{"issue":"10223","key":"10.6061\/clinics\/2021\/e2342_bib54","doi-asserted-by":"crossref","first-page":"497","DOI":"10.1016\/S0140-6736(20)30183-5","article-title":"Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China","volume":"395","author":"Huang","year":"2020","journal-title":"Lancet"},{"key":"10.6061\/clinics\/2021\/e2342_bib55","doi-asserted-by":"crossref","first-page":"e94","DOI":"10.1017\/S0950268820000977","article-title":"Characteristics of disease progress in patients with coronavirus disease 2019 in Wuhan, China","volume":"148","author":"Ji","year":"2020","journal-title":"Epidemiol Infect"},{"key":"10.6061\/clinics\/2021\/e2342_bib56","doi-asserted-by":"crossref","first-page":"128","DOI":"10.1016\/j.ijid.2020.03.053","article-title":"Clinical characteristics of 25 death cases with COVID-19: A retrospective review of medical records in a single medical center, Wuhan, China","volume":"94","author":"Li","year":"2020","journal-title":"Int J Infect Dis"},{"issue":"5","key":"10.6061\/clinics\/2021\/e2342_bib57","doi-asserted-by":"crossref","first-page":"460","DOI":"10.1001\/jama.2020.10044","article-title":"Effect of Convalescent Plasma Therapy on Time to Clinical Improvement in Patients With Severe and Life-threatening COVID-19: A Randomized Clinical Trial","volume":"324","author":"Li","year":"2020","journal-title":"JAMA"},{"issue":"8","key":"10.6061\/clinics\/2021\/e2342_bib58","doi-asserted-by":"crossref","first-page":"1081","DOI":"10.1001\/jamainternmed.2020.2033","article-title":"Development and Validation of a Clinical Risk Score to Predict the Occurrence of Critical Illness in Hospitalized Patients With COVID-19","volume":"180","author":"Liang","year":"2020","journal-title":"JAMA Intern Med"},{"issue":"6","key":"10.6061\/clinics\/2021\/e2342_bib59","doi-asserted-by":"crossref","first-page":"683","DOI":"10.1001\/jamaneurol.2020.1127","article-title":"Neurologic Manifestations of Hospitalized Patients With Coronavirus Disease 2019 in Wuhan, China","volume":"77","author":"Mao","year":"2020","journal-title":"JAMA Neurol"},{"issue":"9","key":"10.6061\/clinics\/2021\/e2342_bib60","doi-asserted-by":"crossref","first-page":"750","DOI":"10.2106\/JBJS.20.00390","article-title":"Characteristics and Early Prognosis of COVID-19 Infection in Fracture Patients","volume":"102","author":"Mi","year":"2020","journal-title":"J Bone Joint Surg Am"},{"issue":"7","key":"10.6061\/clinics\/2021\/e2342_bib61","doi-asserted-by":"crossref","first-page":"802","DOI":"10.1001\/jamacardio.2020.0950","article-title":"Association of Cardiac Injury With Mortality in Hospitalized Patients With COVID-19 in Wuhan, China","volume":"5","author":"Shi","year":"2020","journal-title":"JAMA Cardiol"},{"issue":"6","key":"10.6061\/clinics\/2021\/e2342_bib62","doi-asserted-by":"crossref","first-page":"E19","DOI":"10.1111\/jgs.16533","article-title":"Risk Factors for Mortality in 244 Older Adults With COVID-19 in Wuhan, China: A Retrospective Study","volume":"68","author":"Sun","year":"2020","journal-title":"J Am Geriatr Soc"},{"issue":"4","key":"10.6061\/clinics\/2021\/e2342_bib63","doi-asserted-by":"crossref","DOI":"10.1001\/jamanetworkopen.2020.5619","article-title":"Clinical Characteristics of Patients Who Died of Coronavirus Disease 2019 in China","volume":"3","author":"Xie","year":"2020","journal-title":"JAMA Netw Open"},{"key":"10.6061\/clinics\/2021\/e2342_bib64","doi-asserted-by":"crossref","first-page":"91","DOI":"10.1016\/j.ijid.2020.03.017","article-title":"Prevalence of comorbidities and its effects in patients infected with SARS-CoV-2: a systematic review and meta-analysis","volume":"94","author":"Yang","year":"2020","journal-title":"Int J Infect Dis"},{"issue":"12","key":"10.6061\/clinics\/2021\/e2342_bib65","doi-asserted-by":"crossref","first-page":"5641","DOI":"10.7150\/thno.46465","article-title":"Multicenter cohort study demonstrates more consolidation in upper lungs on initial CT increases the risk of adverse clinical outcome in COVID-19 patients","volume":"10","author":"Yu","year":"2020","journal-title":"Theranostics"},{"issue":"7","key":"10.6061\/clinics\/2021\/e2342_bib66","doi-asserted-by":"crossref","first-page":"934","DOI":"10.1001\/jamainternmed.2020.0994","article-title":"Risk Factors Associated With Acute Respiratory Distress Syndrome and Death in Patients With Coronavirus Disease 2019 Pneumonia in Wuhan, China","volume":"180","author":"Wu","year":"2020","journal-title":"JAMA Intern Med"},{"issue":"7","key":"10.6061\/clinics\/2021\/e2342_bib67","doi-asserted-by":"crossref","first-page":"1730","DOI":"10.1111\/all.14238","article-title":"Clinical characteristics of 140 patients infected with SARS-CoV-2 in Wuhan, China","volume":"75","author":"Zhang","year":"2020","journal-title":"Allergy"},{"issue":"16","key":"10.6061\/clinics\/2021\/e2342_bib68","doi-asserted-by":"crossref","first-page":"1612","DOI":"10.1001\/jama.2020.4326","article-title":"Characteristics and Outcomes of 21 Critically Ill Patients With COVID-19 in Washington State","volume":"323","author":"Arentz","year":"2020","journal-title":"JAMA"},{"issue":"25","key":"10.6061\/clinics\/2021\/e2342_bib69","doi-asserted-by":"crossref","first-page":"2411","DOI":"10.1056\/NEJMoa2012410","article-title":"Observational Study of Hydroxychloroquine in Hospitalized Patients with Covid-19","volume":"382","author":"Geleris","year":"2020","journal-title":"N Engl J Med"},{"issue":"24","key":"10.6061\/clinics\/2021\/e2342_bib70","doi-asserted-by":"crossref","first-page":"2372","DOI":"10.1056\/NEJMc2010419","article-title":"Clinical Characteristics of Covid-19 in New York City","volume":"382","author":"Goyal","year":"2020","journal-title":"N Engl J Med"},{"issue":"9","key":"10.6061\/clinics\/2021\/e2342_bib71","doi-asserted-by":"crossref","first-page":"1036","DOI":"10.1001\/jamacardio.2020.1834","article-title":"Risk of QT Interval Prolongation Associated With Use of Hydroxychloroquine With or Without Concomitant Azithromycin Among Hospitalized Patients Testing Positive for Coronavirus Disease 2019 (COVID-19)","volume":"5","author":"Mercuro","year":"2020","journal-title":"JAMA Cardiol"},{"issue":"21","key":"10.6061\/clinics\/2021\/e2342_bib72","doi-asserted-by":"crossref","first-page":"2195","DOI":"10.1001\/jama.2020.7202","article-title":"Characteristics of Hospitalized Adults With COVID-19 in an Integrated Health Care System in California","volume":"323","author":"Myers","year":"2020","journal-title":"JAMA"},{"issue":"26","key":"10.6061\/clinics\/2021\/e2342_bib73","doi-asserted-by":"crossref","first-page":"2534","DOI":"10.1056\/NEJMsa2011686","article-title":"Hospitalization and Mortality among Black Patients and White Patients with Covid-19","volume":"382","author":"Price-Haywood","year":"2020","journal-title":"N Engl J Med"},{"issue":"20","key":"10.6061\/clinics\/2021\/e2342_bib74","doi-asserted-by":"crossref","first-page":"2052","DOI":"10.1001\/jama.2020.6775","article-title":"Presenting Characteristics, Comorbidities, and Outcomes Among 5700 Patients Hospitalized With COVID-19 in the New York City Area","volume":"323","author":"Richardson","year":"2020","journal-title":"JAMA"},{"issue":"2","key":"10.6061\/clinics\/2021\/e2342_bib75","doi-asserted-by":"crossref","first-page":"768","DOI":"10.1053\/j.gastro.2020.04.064","article-title":"Clinical Characteristics and Outcomes of Coronavirus Disease 2019 Among Patients With Preexisting Liver Disease in the United States: A Multicenter Research Network Study","volume":"159","author":"Singh","year":"2020","journal-title":"Gastroenterology"},{"issue":"16","key":"10.6061\/clinics\/2021\/e2342_bib76","doi-asserted-by":"crossref","first-page":"1574","DOI":"10.1001\/jama.2020.5394","article-title":"Baseline Characteristics and Outcomes of 1591 Patients Infected With SARS-CoV-2 Admitted to ICUs of the Lombardy Region, Italy","volume":"323","author":"Grasselli","year":"2020","journal-title":"JAMA"},{"issue":"5","key":"10.6061\/clinics\/2021\/e2342_bib77","first-page":"271","article-title":"Clinical Characterization of 162 COVID-19 patients in Israel: Preliminary Report from a Large Tertiary Center","volume":"22","author":"Itelman","year":"2020","journal-title":"Isr Med Assoc J"},{"issue":"5","key":"10.6061\/clinics\/2021\/e2342_bib78","doi-asserted-by":"crossref","DOI":"10.1001\/jamanetworkopen.2020.10478","article-title":"Venous Thrombosis Among Critically Ill Patients With Coronavirus Disease 2019 (COVID-19)","volume":"3","author":"Nahum","year":"2020","journal-title":"JAMA Netw Open"},{"issue":"4","key":"10.6061\/clinics\/2021\/e2342_bib79","doi-asserted-by":"crossref","DOI":"10.1001\/jamanetworkopen.2020.8857","article-title":"Effect of High vs Low Doses of Chloroquine Diphosphate as Adjunctive Therapy for Patients Hospitalized With Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) Infection: A Randomized Clinical Trial","volume":"3","author":"Borba","year":"2020","journal-title":"JAMA Netw Open"},{"issue":"24","key":"10.6061\/clinics\/2021\/e2342_bib80","doi-asserted-by":"crossref","first-page":"2327","DOI":"10.1056\/NEJMoa2007016","article-title":"Compassionate Use of Remdesivir for Patients with Severe Covid-19","volume":"382","author":"Grein","year":"2020","journal-title":"N Engl J Med"},{"issue":"19","key":"10.6061\/clinics\/2021\/e2342_bib81","doi-asserted-by":"crossref","first-page":"1827","DOI":"10.1056\/NEJMoa2015301","article-title":"Remdesivir for 5 or 10 Days in Patients with Severe Covid-19","volume":"383","author":"Goldman","year":"2020","journal-title":"N Engl J Med"},{"key":"10.6061\/clinics\/2021\/e2342_bib82","article-title":"Features of 20 133 UK patients in hospital with covid-19 using the ISARIC WHO Clinical Characterisation Protocol: prospective observational cohort study","volume":"369","author":"Docherty","year":"2020","journal-title":"BMJ"},{"issue":"4","key":"10.6061\/clinics\/2021\/e2342_bib83","doi-asserted-by":"crossref","first-page":"283","DOI":"10.1016\/j.dsx.2020.03.016","article-title":"Comorbidities in COVID-19: Outcomes in hypertensive cohort and controversies with renin angiotensin system blockers","volume":"14","author":"Singh","year":"2020","journal-title":"Diabetes Metab Syndr"},{"issue":"4","key":"10.6061\/clinics\/2021\/e2342_bib84","first-page":"304","article-title":"Hypertension in patients with coronavirus disease 2019 (COVID-19): a pooled analysis","volume":"130","author":"Lippi","year":"2020","journal-title":"Pol Arch Intern Med"},{"issue":"6","key":"10.6061\/clinics\/2021\/e2342_bib85","doi-asserted-by":"crossref","first-page":"1231","DOI":"10.1007\/s10157-018-1567-1","article-title":"Independent regulation of renin-angiotensin-aldosterone system in the kidney","volume":"22","author":"Nishiyama","year":"2018","journal-title":"Clin Exp Nephrol"},{"issue":"8 Suppl B","key":"10.6061\/clinics\/2021\/e2342_bib86","first-page":"9","article-title":"The renin-angiotensin aldosterone system: pathophysiological role and pharmacologic inhibition","volume":"13","author":"Atlas","year":"2007","journal-title":"J Manag Care Pharm"},{"issue":"4","key":"10.6061\/clinics\/2021\/e2342_bib87","doi-asserted-by":"crossref","first-page":"258","DOI":"10.1093\/ehjcvp\/pvaa042","article-title":"Statin therapy in COVID-19 infection","volume":"6","author":"Castiglione","year":"2020","journal-title":"Eur Heart J Cardiovasc Pharmacother"},{"issue":"2","key":"10.6061\/clinics\/2021\/e2342_bib88","doi-asserted-by":"crossref","first-page":"375","DOI":"10.1097\/HJH.0b013e32834f04b6","article-title":"Circulating ACE2 activity is increased in patients with type 1 diabetes and vascular complications","volume":"30","author":"Soro-Paavonen","year":"2012","journal-title":"J Hypertens"},{"issue":"8","key":"10.6061\/clinics\/2021\/e2342_bib89","doi-asserted-by":"crossref","first-page":"875","DOI":"10.1038\/nm1267","article-title":"A crucial role of angiotensin converting enzyme 2 (ACE2) in SARS coronavirus-induced lung injury","volume":"11","author":"Kuba","year":"2005","journal-title":"Nat Med"},{"issue":"6","key":"10.6061\/clinics\/2021\/e2342_bib90","doi-asserted-by":"crossref","first-page":"305","DOI":"10.1038\/s41581-020-0279-4","article-title":"Controversies of renin-angiotensin system inhibition during the COVID-19 pandemic","volume":"16","author":"South","year":"2020","journal-title":"Nat Rev Nephrol"},{"issue":"7","key":"10.6061\/clinics\/2021\/e2342_bib91","doi-asserted-by":"crossref","first-page":"e87","DOI":"10.1093\/cvr\/cvaa096","article-title":"Binding of SARS-CoV-2 and angiotensin-converting enzyme 2: clinical implications","volume":"116","author":"Murray","year":"2020","journal-title":"Cardiovasc Res"},{"issue":"5","key":"10.6061\/clinics\/2021\/e2342_bib92","doi-asserted-by":"crossref","first-page":"135","DOI":"10.4330\/wjc.v4.i5.135","article-title":"Hypertension in the elderly","volume":"4","author":"Lionakis","year":"2012","journal-title":"World J Cardiol"},{"issue":"5","key":"10.6061\/clinics\/2021\/e2342_bib93","doi-asserted-by":"crossref","first-page":"926","DOI":"10.1111\/jgs.16472","article-title":"COVID-19 and Older Adults: What We Know","volume":"68","author":"Shahid","year":"2020","journal-title":"J Am Geriatr Soc"},{"issue":"1","key":"10.6061\/clinics\/2021\/e2342_bib94","doi-asserted-by":"crossref","first-page":"757","DOI":"10.1080\/22221751.2020.1746200","article-title":"Renin-angiotensin system inhibitors improve the clinical outcomes of COVID-19 patients with hypertension","volume":"9","author":"Meng","year":"2020","journal-title":"Emerg Microbes Infect"},{"issue":"25","key":"10.6061\/clinics\/2021\/e2342_bib95","doi-asserted-by":"crossref","first-page":"e102","DOI":"10.1056\/NEJMoa2007621","article-title":"Cardiovascular Disease, Drug Therapy, and Mortality in Covid-19","volume":"382","author":"Mehra","year":"2020","journal-title":"N Engl J Med"},{"issue":"26","key":"10.6061\/clinics\/2021\/e2342_bib96","doi-asserted-by":"crossref","DOI":"10.1056\/NEJMc2021225","article-title":"Retraction: Cardiovascular Disease, Drug Therapy, and Mortality in Covid-19","volume":"382","author":"Mehra","year":"2020","journal-title":"N Engl J Med"},{"key":"10.6061\/clinics\/2021\/e2342_bib97","doi-asserted-by":"crossref","DOI":"10.1056\/NEJMe2020822","article-title":"Expression of Concern: Mehra MR et al. Cardiovascular Disease, Drug Therapy, and Mortality in Covid-19","volume":"382","author":"Rubin","year":"2020","journal-title":"N Engl J Med"},{"issue":"19","key":"10.6061\/clinics\/2021\/e2342_bib98","doi-asserted-by":"crossref","first-page":"1519","DOI":"10.1136\/heartjnl-2020-317336","article-title":"Treatment with ACE inhibitors or ARBs and risk of severe\/lethal COVID-19: a meta-analysis","volume":"106","author":"Flacco","year":"2020","journal-title":"Heart"},{"issue":"2","key":"10.6061\/clinics\/2021\/e2342_bib99","doi-asserted-by":"crossref","first-page":"148","DOI":"10.1093\/ehjcvp\/pvaa064","article-title":"A systematic review and meta-analysis to evaluate the clinical outcomes in COVID-19 patients on angiotensin-converting enzyme inhibitors or angiotensin receptor blockers","volume":"7","author":"Grover","year":"2021","journal-title":"Eur Heart J Cardiovasc Pharmacother"},{"issue":"5","key":"10.6061\/clinics\/2021\/e2342_bib100","doi-asserted-by":"crossref","first-page":"983","DOI":"10.1016\/j.dsx.2020.06.047","article-title":"The use of renin angiotensin system inhibitor on mortality in patients with coronavirus disease 2019 (COVID-19): A systematic review and meta-analysis","volume":"14","author":"Pranata","year":"2020","journal-title":"Diabetes Metab Syndr"},{"issue":"2","key":"10.6061\/clinics\/2021\/e2342_bib101","doi-asserted-by":"crossref","first-page":"276","DOI":"10.1016\/j.jinf.2020.05.052","article-title":"Estimation of Renin-Angiotensin-Aldosterone-System (RAAS)-Inhibitor effect on COVID-19 outcome: A Meta-analysis","volume":"81","author":"Pirola","year":"2020","journal-title":"J Infect"},{"issue":"2","key":"10.6061\/clinics\/2021\/e2342_bib102","doi-asserted-by":"crossref","first-page":"e13","DOI":"10.1161\/HYPERTENSIONAHA.120.15572","article-title":"Decreased Mortality of COVID-19 With Renin-Angiotensin-Aldosterone System Inhibitors Therapy in Patients With Hypertension: A Meta-Analysis","volume":"76","author":"Guo","year":"2020","journal-title":"Hypertension"},{"key":"10.6061\/clinics\/2021\/e2342_bib103","article-title":"Association of angiotensin converting enzyme inhibitors and angiotensin II receptor blockers with risk of COVID-19, inflammation level, severity, and death in patients with COVID-19: A rapid systematic review and meta-analysis","author":"Liu","year":"2020","journal-title":"Clin Cardiol"},{"issue":"6","key":"10.6061\/clinics\/2021\/e2342_bib104","doi-asserted-by":"crossref","first-page":"503","DOI":"10.1177\/1074248420947628","article-title":"Renin-Angiotensin System Blockade and Mortality in Patients With Hypertension and COVID-19 Infection","volume":"25","author":"Salah","year":"2020","journal-title":"J Cardiovasc Pharmacol Ther"},{"key":"10.6061\/clinics\/2021\/e2342_bib105","author":"American College of Cardiology"},{"key":"10.6061\/clinics\/2021\/e2342_bib106","author":"European Society of Cardiology"},{"key":"10.6061\/clinics\/2021\/e2342_bib107","author":"Canadian Cardiovascular Society"},{"key":"10.6061\/clinics\/2021\/e2342_bib108","author":"Departamento de Insufici\u00eancia Card\u00edaca (DEIC)"}],"container-title":["Clinics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S1807593222000904?httpAccept=text\/xml","content-type":"text\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S1807593222000904?httpAccept=text\/plain","content-type":"text\/plain","content-version":"vor","intended-application":"text-mining"}],"deposited":{"date-parts":[[2025,10,29]],"date-time":"2025-10-29T06:58:04Z","timestamp":1761721084000},"score":1,"resource":{"primary":{"URL":"https:\/\/linkinghub.elsevier.com\/retrieve\/pii\/S1807593222000904"},"secondary":[{"URL":"https:\/\/www.scielo.br\/scielo.php?script=sci_arttext&pid=S1807-59322021000100408&lng=en&nrm=iso","label":"SCIELO"},{"URL":"https:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC8009081\/","label":"PMC"},{"URL":"https:\/\/www.clinicsjournal.com\/article\/renin-angiotensin-aldosterone-system-inhibitors-in-covid-19-a-review\/","label":"CLINICS"}]},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021]]},"references-count":108,"alternative-id":["S1807593222000904"],"URL":"https:\/\/doi.org\/10.6061\/clinics\/2021\/e2342","relation":{},"ISSN":["1807-5932"],"issn-type":[{"value":"1807-5932","type":"print"}],"subject":[],"published":{"date-parts":[[2021]]},"assertion":[{"value":"Elsevier","name":"publisher","label":"This article is maintained by"},{"value":"Renin-Angiotensin-Aldosterone System Inhibitors in COVID-19: A Review","name":"articletitle","label":"Article Title"},{"value":"Clinics","name":"journaltitle","label":"Journal Title"},{"value":"https:\/\/doi.org\/10.6061\/clinics\/2021\/e2342","name":"articlelink","label":"CrossRef DOI link to publisher maintained version"},{"value":"article","name":"content_type","label":"Content Type"},{"value":"Copyright \u00a9 2021 CLINICS. Published by Elsevier Spain","name":"copyright","label":"Copyright"}],"article-number":"e2342"}}