Introduction Renin-angiotensin system (RAS) inhibitors have been postulated to influence susceptibility to Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2). This study investigated whether there is an association between their prescription and the incidence of COVID-19 and all-cause mortality. Methods We conducted a propensity-score matched cohort study comparing the incidence of COVID-19 among patients with hypertension prescribed angiotensin-converting enzyme I (ACE) inhibitors or angiotensin II type-1 receptor blockers (ARBs) to those treated with calcium channel blockers (CCBs) in a large UK-based primary care database (The Health Improvement Network). We estimated crude incidence rates for confirmed/suspected COVID-19 in each drug exposure group. We used Cox proportional hazards models to produce adjusted hazard ratios for COVID-19. We assessed all-cause mortality as a secondary outcome. Results The incidence rate of COVID-19 among users of ACE inhibitors and CCBs was 9.3 per 1000 person-years (83 of 18,895 users [0.44%]) and 9.5 per 1000 person-years (85 of 18,895 [0.45%]), respectively. The adjusted hazard ratio was 0.92 (95% CI 0.68 to 1.26). The incidence rate among users of ARBs was 15.8 per 1000 person-years (79 out of 10,623 users [0.74%]). The adjusted hazard ratio was 1.38 (95% CI 0.98 to 1.95). There were no significant associations between use of RAS inhibitors and all-cause mortality. Conclusion Use of ACE inhibitors was not associated with the risk of COVID-19 whereas use of ARBs was associated with a statistically non-significant increase compared to the use of CCBs. However, no significant associations were observed between prescription of either ACE inhibitors or ARBs and all-cause mortality. Supplementary Information The online version contains supplementary material available at 10.1186/s12879-021-05951-w.
【초록키워드】 COVID-19, SARS-CoV-2, primary care, susceptibility, hypertension, database, RAS, cohort study, ARB, improvement, Patient, incidence rate, ACE inhibitor, network, receptor, respiratory, inhibitor, association, Angiotensin-converting enzyme, CCB, ACE, ARBs, supplementary material, 95% CI, adjusted hazard ratio, all-cause mortality, secondary outcome, CCBs, blocker, risk of COVID-19, Result, investigated, conducted, treated, statistically, 1.26, Cox proportional hazard, exposure group, incidence of COVID-19, per 1000 person-year, RAS inhibitor, 【제목키워드】 primary care, susceptibility, cohort study, inhibitor, COVID-19 in patient,