ACE Inhibitor, ARB Treatments Not Found to Increase Rates of COVID-19 Infection, Mortality

Treatment with ACEI and/or ARBs was not found to increase the rates of COVID-19 infection or associated mortality.

This article is part of Cardiology Advisor‘s coverage of AHA Scientific Sessions 2020.

Treatment with angiotensin-converting enzyme inhibitors (ACEI) and/or angiotensin-receptor blockers (ARBs) was not found to increase the rates of coronavirus disease 2019 (COVID-19) infection or associated mortality, according to study results presented at the American Heart Association (AHA) Scientific Sessions 2020, held virtually from November 13 to 17, 2020.

These were 2 meta-analyses of studies in which in-hospital mortality of patients with COVID-19 (n=14) and COVID-19 positivity rates (n=3) were examined among patients who were treated vs not treated with ACEI or/and ARB.

COVID-19 testing positivity rates were found to be comparable in patients treated vs not treated with ACEI (odds ratio [OR], 0.96; 95% CI, 0.88-1.04; P =.69), and in those taking vs not taking ARBs (OR, 0.99; 95% CI, 0.91-1.08; P =.35).

In the second analysis, in-hospital mortality rates of patients with COVID-19 were similar for patients treated vs not treated with ACEI and/or ARB (hazard ratio [HR], 0.88; 95% CI, 0.64-1.20; P =.42). In a sub-analysis that included only patients with hypertension, the use of ACEI and/or ARB was associated with a significant reduction in in-hospital mortality (HR, 0.65; 95% CI, 0.48-0.87).

 “Our study results confirm that patients already taking ACE inhibitors and ARBs should not discontinue taking them due to COVID-19 infection,” noted lead study author Yujiro Yokoyama, MD, of Saint Luke’s University Health Network’s Easton Hospital in Pennsylvania.


Yokoyama Y, Takagi H, Aikawa T, Kuno T. Meta-analyses for the effect of renin-angiotensin-aldosterone system inhibitors on mortality and testing positive of COVID-19. Presented at: AHA Scientific Sessions 2020; November 13-17, 2020. Presentation 399.

Visit Cardiology Advisor‘s conference section for continuous coverage from AHA 2020.