Update on association between exposure to renin-angiotensin-aldosterone system inhibitors and coronavirus disease 2019 in South Korea

Korean J Intern Med. 2020 Aug 21. doi: 10.3904/kjim.2020.380. Online ahead of print.

Abstract

Background/aims: Since the onset of the coronavirus disease 2019 (COVID-19) pandemic, there have been concerns about the association between exposure to renin-angiotensin-aldosterone system (RAAS) inhibitors and the risk and severity of COVID-19.

Methods: We performed a case-control study that utilized up-to-date data on the South Korean population provided by the Korean National Health Insurance System. Of the 62,909 patients with hypertension or heart failure tested for COVID-19, there were 1,644 (2.6%) confirmed cases. After case-control matching, multivariable-adjusted conditional logistic regression analysis was performed.

Results: Comparison between patients exposed to RAAS inhibitors and those not exposed to RAAS inhibitors revealed that the adjusted odds ratio (OR) and 95% confidence interval (95% CI) for COVID-19 infection and death were 0.981 (0.849-1.135) and 0.875 (0.548-1.396), respectively. Subgroup analysis for the major confounders, age and region of diagnosis, resulted in OR and 95% CI of 0.912 (0.751-1.108) and 0.942 (0.791-1.121), respectively.

Conclusions: The present study demonstrated no evidence of association between RAAS inhibitor exposure and risk and severity of COVID-19.

Keywords: ACE inhibitor; ARB; COVID-19; RAAS inhibitor; hypertension.