Previous studies have suggested a potential association between the use of angiotensin-receptor blockers (ARBs) and angiotensin-converting-enzyme (ACE) inhibitors and the risk of COVID-19. The authors conducted a population-based case-control study in the Lombardy region of Italy. 6272 COVID-19 case-patients were matched to 30,759 controls according to sex, age and municipality of residence. The mean age of both case-patients and controls was 68 years, and 37% were women. The use of ACE inhibitors and ARBs was found to be more common among case-patients than among controls, as was the use of other antihypertensive and non-antihypertensive drugs, and case-patients had a worse clinical profile. The use of ARBs or ACE inhibitors did not show any association with COVID-19 among case-patients overall or among patients who had a severe or fatal course of the disease, and no association between these variables was found according to sex. Therefore, while the use of ACE inhibitors and ARBs is more frequent among patients with COVID-19 than among controls, this is because of their higher prevalence of cardiovascular disease and their use does not appear to affect the risk of COVID-19.
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