PT  - JOURNAL ARTICLE
AU  - Christian Fynbo Christiansen
AU  - Anton Pottegård
AU  - Uffe Heide-Jørgensen
AU  - Jacob Bodilsen
AU  - Ole Schmeltz Søgaard
AU  - Michael Maeng
AU  - Simon Tilma Vistisen
AU  - Morten Schmidt
AU  - Lars Christian Lund
AU  - Mette Reilev
AU  - Jesper Hallas
AU  - Marianne Voldstedlund
AU  - Anders Husby
AU  - Marianne Kragh Thomsen
AU  - Nanna Borup Johansen
AU  - Nikolai Constantin Brun
AU  - Reimar Wernich Thomsen
AU  - Hans Erik Bøtker
AU  - Henrik Toft Sørensen
TI  - SARS-CoV-2 infection and adverse outcomes in users of ACE inhibitors and angiotensin-receptor blockers: a nationwide case-control and cohort analysis
AID  - 10.1136/thoraxjnl-2020-215768
DP  - 2021 Apr 01
TA  - Thorax
PG  - 370--379
VI  - 76
IP  - 4
4099  - http://thorax.bmj.com/content/76/4/370.short
4100  - http://thorax.bmj.com/content/76/4/370.full
SO  - Thorax2021 Apr 01; 76
AB  - Objective To examine the impact of ACE inhibitor (ACE-I)/angiotensin receptor blocker (ARB) use on rate of SARS-CoV-2 infection and adverse outcomes.Methods This nationwide case-control and cohort study included all individuals in Denmark tested for SARS-CoV-2 RNA with PCR from 27 February 2020 to 26 July 2020. We estimated confounder-adjusted ORs for a positive test among all SARS-CoV-2 tested, and inverse probability of treatment weighted 30-day risk and risk ratios (RRs) of hospitalisation, intensive care unit (ICU) admission and mortality comparing current ACE-I/ARB use with calcium channel blocker (CCB) use and with non-use.Results The study included 13 501 SARS-CoV-2 PCR-positive and 1 088 695 PCR-negative individuals. Users of ACE-I/ARB had a marginally increased rate of a positive PCR when compared with CCB users (aOR 1.17, 95% CI 1.00 to 1.37), but not when compared with non-users (aOR 1.00 95% CI 0.92 to 1.09).Among PCR-positive individuals, 1466 (11%) were ACE-I/ARB users. The weighted risk of hospitalisation was 36.5% in ACE-I/ARB users and 43.3% in CCB users (RR 0.84, 95% CI 0.70 to 1.02). The risk of ICU admission was 6.3% in ACE-I/ARB users and 5.4% in CCB users (RR 1.17, 95% CI 0.64 to 2.16), while the 30-day mortality was 12.3% in ACE-I/ARB users and 13.9% in CCB users (RR 0.89, 95% CI 0.61 to 1.30). The associations were similar when ACE-I/ARB users were compared with non-users.Conclusions ACE-I/ARB use was associated neither with a consistently increased rate nor with adverse outcomes of SARS-CoV-2 infection. Our findings support the current recommendation of continuing use of ACE-Is/ARBs during the SARS-CoV-2 pandemic.Trial registration number EUPAS34887