ABSTRACT
Quinn et al examine the role of renin-angiotensin-aldosterone system (RAAS) inhibitors in patients with coronavirus disease 2019 (COVID-19). Three large observational studies of more than 20,000 patients with COVID-19 found no association between the use of RAAS inhibitors and increased risk of infection, development of severe disease or death. The 3 studies used different methodological approaches, and all came to similar conclusions. A different cohort study of 18,472 patients who were tested for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) also found no association between RAAS inhibitor use and testing positive for COVID-19. However, a secondary analysis of 1,735 patients in the study with confirmed COVID-19 showed an increased risk of severe disease requiring admission to the intensive care unit in patients using RAAS inhibitors. All observational studies are at risk of unmeasured confounding. However, according to the results across these studies, RAAS inhibitors are unlikely to cause harm in patients with COVID-19.