Renin-angiotensin system antagonists are associated with lower mortality in hypertensive patients with COVID-19.

The use of angiotensin-converting enzyme inhibitors (ACEIs) and angiotensin-receptor blockers (ARBs) in patients with Coronavirus 2019 (COVID-19) has been controversial. We performed a meta-analysis of all published studies that reported the outcomes of ACEIs/ARBs in patients with COVID-19. We included four observational studies (3,267 patients). The use of ACEIs/ARBs was associated with a similar risk of all-cause death (OR: 0.75, 95% CI [0.36, 1.57], p = 0.45). Sensitivity analysis including only hypertensive patients demonstrated a lower risk of death with ACEIs/ARBs use (OR: 0.57, 95% CI [0.32-0.98], p = 0.04). In conclusion, hypertensive patients with COVID-19 treated with ACEIs/ARBS have a lower mortality but further research is needed.