BACKGROUND A potential association between the use of angiotensin-receptor blockers (ARBs) and angiotensin-converting-enzyme (ACE) inhibitors and the risk of coronavirus disease 2019 (Covid-19) has not been well studied. METHODS We carried out a population-based case-control study in the Lombardy region of Italy. A total of 6272 case patients in whom infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) was confirmed between February 21 and March 11, 2020, were matched to 30,759 beneficiaries of the Regional Health Service (controls) according to sex, age, and municipality of residence. Information about the use of selected drugs and patients' clinical profiles was obtained from regional databases of health care use. Odds ratios and 95% confidence intervals for associations between drugs and infection, with adjustment for confounders, were estimated by means of logistic regression. RESULTS Among both case patients and controls, the mean (±SD) age was 68±13 years, and 37% were women. The use of ACE inhibitors and ARBs was more common among case patients than among controls, as was the use of other antihypertensive and non-antihypertensive drugs, and case patients had a worse clinical profile. Use of ARBs or ACE inhibitors did not show any association with Covid-19 among case patients overall (adjusted odds ratio, 0.95 [95% confidence interval {CI}, 0.86 to 1.05] for ARBs and 0.96 [95% CI, 0.87 to 1.07] for ACE inhibitors) or among patients who had a severe or fatal course of the disease (adjusted odds ratio, 0.83 [95% CI, 0.63 to 1.10] for ARBs and 0.91 [95% CI, 0.69 to 1.21] for ACE inhibitors), and no association between these variables was found according to sex. CONCLUSIONS In this large, population-based study, the use of ACE inhibitors and ARBs was more frequent among patients with Covid-19 than among controls because of their higher prevalence of cardiovascular disease. However, there was no evidence that ACE inhibitors or ARBs affected the risk of COVID-19.

中文翻译：

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肾素-血管紧张素-醛固酮系统阻滞剂和 Covid-19 的风险。

背景 血管紧张素受体阻滞剂 (ARB) 和血管紧张素转换酶 (ACE) 抑制剂的使用与 2019 年冠状病毒病 (Covid-19) 风险之间的潜在关联尚未得到充分研究。方法 我们在意大利伦巴第地区进行了一项基于人群的病例对照研究。2020 年 2 月 21 日至 3 月 11 日期间，共有 6272 名确诊感染严重急性呼吸综合征冠状病毒 2 (SARS-CoV-2) 的患者，根据性别与地区卫生服务（对照）的 30,759 名受益人进行了匹配、年龄和居住城市。有关所选药物的使用和患者临床概况的信息是从医疗保健使用的区域数据库中获得的。通过逻辑回归估计药物与感染之间关联的比值比和 95% 置信区间，并调整混杂因素。结果 在病例患者和对照组中，平均 (±SD) 年龄均为 68±13 岁，其中 37% 为女性。病例患者中ACE抑制剂和ARB的使用比对照组更常见，其他抗高血压和非抗高血压药物的使用也是如此，并且病例患者的临床特征更差。总体而言，ARB 或 ACE 抑制剂的使用与 Covid-19 没有任何关联（调整后的比值比，ARB 为 0.95 [95% 置信区间 {CI}，0.86 至 1.05]，ARB 为 0.96 [95% CI，0.87 至 1.07] ] 对于 ACE 抑制剂）或患有严重或致命病程的患者（调整后的比值比，ARB 为 0.83 [95% CI，0.63 至 1.10]，ACE 抑制剂为 0.91 [95% CI，0.69 至 1.21]） ，并且根据性别未发现这些变量之间存在关联。结论 在这项基于人群的大型研究中，Covid-19 患者比对照组更频繁地使用 ACE 抑制剂和 ARB，因为他们的心血管疾病患病率较高。然而，没有证据表明 ACE 抑制剂或 ARB 会影响 COVID-19 的风险。