Background/Aims@#There are concerns that the use of
renin-angiotensin system (
RAS ) blockers may increase the
risk of being infected with
severe acute respiratory syndrome coronavirus 2 (
SARS-CoV-2 ) or progressing to a severe
clinical course after
infection . This this study aimed to investigate the influence of
RAS blockers on the
risk and severity of SARS-CoV-2 infection. @*
Methods @#We conducted a retrospective
cohort study analyzing nationwide claims data of 215,184
adults who underwent
SARS-CoV-2 tests in
South Korea . The
SARS-CoV-2 positive rates and clinical outcomes were evaluated according to the use of
RAS blockers in
patients with
hypertension (n = 64,243). @*Results@#In total, 38,919
patients with
hypertension were on
RAS blockers. The
SARS-CoV-2 positive rates were significantly higher in the
RAS blocker group than in the
control group after
adjustments (adjusted
odds ratio [OR], 1.22; 95%
confidence interval [CI], 1.10 to 1.36; p < 0.001), and matching by
propensity score (adjusted OR, 1.16; 95% CI, 1.03 to 1.32; p = 0.017). Among the 1,609
SARS-CoV-2 -positive
patients with
hypertension , the use of
RAS blockers was not associated with poor outcomes, such as
mortality (adjusted OR, 0.81; 95% CI, 0.56 to 1.17; p = 0.265), and a composite of admission to the
intensive care unit and
mortality (adjusted OR, 0.95; 95% CI, 0.73 to 1.22; p = 0.669).
Analysis in the propensity scorematched
population showed consistent results. @*Conclusions@#In this Korean nationwide claims
dataset , the use of
RAS blockers was associated with a higher
risk to SARS-CoV-2 infection but not with higher
mortality or other severe clinical
courses .