{"doi":"10.1093/ehjcvp/pvaa138","title":"Renin–angiotensin system blockers, risk of SARS-CoV-2 infection and outcomes from CoViD-19: systematic review and meta-analysis","abstract":"AIMS: This meta-analysis provides summary odds ratio (OR) estimates for associations between treatment with (vs. without) renin-angiotensin system blockers and risk of severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2) infection and coronavirus disease 2019 (CoViD-19) severity (including case-fatality) in patients with hypertension, and in all patients (irrespective of hypertension). METHODS AND RESULTS: PubMed, EMBASE, Web of Science, Google Scholar, medRxiv, and SSRN were searched (2 May 2020 to 12 August 2020) for non-randomized observational CoViD-19 studies. Event/patient numbers were extracted, comparing angiotensin-converting enzyme (ACE) inhibitor/angiotensin-receptor blocker (ARB) treatment (and each separately), to treatment with neither drug, for the outcomes: (i) likelihood of SARS-CoV-2 infection; (ii) CoViD-19 severity [including hospitalization, intensive therapy unit (ITU), ventilation]; (iii) case-fatality. The risk of bias was assessed (ROBINS-I). Random-effects meta-analysis estimates were pooled. Eighty-six studies including 459 755 patients (103 317 with hypertension), were analysed. In patients with hypertension, ACE inhibitor or ARB treatment was not associated with a greater likelihood of SARS-CoV-2 infection in 60 141 patients (OR 1.06, 95% CI 0.99-1.14), hospitalization in 5925 patients (OR 0.90, 0.62-1.31), ITU in 7218 patients (OR 1.06, 0.73-1.56), ventilation (or ITU/ventilation/death) in 13 163 patients (OR 0.91, 0.72-1.15) or case-fatality in 18 735 patients with 2893 deaths (OR 0.75, 0.61-0.92). CONCLUSION: Angiotensin-converting enzyme inhibitors and ARBs appear safe in the context of SARS-CoV-2 infection and should not be discontinued.PROSPERO registration number CRD42020186996.","journal":"European Heart Journal - Cardiovascular Pharmacotherapy","year":2020,"id":63659,"datarank":0.5676284450877392,"base_score":3.784189633918261,"endowment":3.784189633918261,"self_citation_contribution":0.5676284450877392,"citation_network_contribution":0.0,"self_endowment_contribution":0.5676284450877392,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":43,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.9569,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2020-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":57279,"name":"Kieran F. Docherty","orcid":"0000-0002-5446-9969","position":1,"is_corresponding":false},{"id":42051,"name":"Naveed Sattar","orcid":"0000-0002-1604-2593","position":2,"is_corresponding":false},{"id":262179,"name":"Neil Mehta","orcid":"0000-0001-8342-4252","position":3,"is_corresponding":false},{"id":262183,"name":"Ankur Kalra","orcid":"0000-0003-0080-1660","position":4,"is_corresponding":false},{"id":336841,"name":"Amy S. Nowacki","orcid":"0000-0002-1216-1448","position":5,"is_corresponding":false},{"id":27970,"name":"Scott D. Solomon","orcid":"0000-0003-3698-9597","position":6,"is_corresponding":false},{"id":61406,"name":"Muthiah Vaduganathan","orcid":"0000-0003-0885-1953","position":7,"is_corresponding":false},{"id":57272,"name":"Mark C. Petrie","orcid":"0000-0002-6333-9496","position":8,"is_corresponding":false},{"id":57280,"name":"Pardeep S. Jhund","orcid":"0000-0003-4306-5317","position":9,"is_corresponding":false},{"id":2612,"name":"John J.V. McMurray","orcid":"0000-0002-6317-3975","position":10,"is_corresponding":false},{"id":336840,"name":"Matthew M.Y. Lee","orcid":"0000-0001-9213-2067","position":0,"is_corresponding":true}],"reference_count":29,"raw_metadata":{"citation_network_status":"fetched"},"created_at":"2026-07-18T21:11:24.000992Z","pmid":"33337478","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}