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TFP #264 – From theory to reality: ACEi, ARB, and COVID-19

Clinical Question: Do angiotensin converting enzyme inhibitors (ACEi) or angiotensin receptor blockers (ARB) increase the risk of catching, or severity of infection with, COVID-19?

Bottom Line: Despite initial theoretical suggestions that ACEi and ARB are harmful, four observational studies have since found no association between COVID-19 infection or severity of disease and ACEi/ARB. One cohort study with the smallest number of COVID-19 patients found an association between ACEi, ARB and hospitalization but not mechanical ventilation. All studies have limitations associated with observational studies including potential confounders and bias which require imperfect statistical adjustments.    

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