TABLE 1.

Select characteristics of studies included in the meta-analysis

Study	Study period	Region, location	Patients characteristics	Patients	ACEI or ARB, n	Age, male	Comorbidities	Outcomes
Cohort studies
Zhang et al. [11]	31 December 2019 to 20 February 2020	Wuhan, China	In-hospital patients with COVID-19 and hypertension	1128	188	64, 53%	HTN 100% DM 21% CVD 12% CKD 3%	28-Day mortality; severe disease
Reynolds et al. [13]	1 March 2020 to 15 April 2020	New York, USA	Patients with COVID-19	2211+	1110	NR++	NR++	Combined end-point of in-hospital mortality or severe disease
Tedeschi et al. [12]	22 February 2020 to 4 April 2020	10 Hospitals across Italy	In-hospital patients with COVID-19 and hypertension	311	175	76, 72%	HTN 100% DM 24% CVD 42%	In-hospital mortality
Jung et al. [14]	Till 8 April 2020	Nationwide database, South Korea	Patients with COVID-19	5179	762	45, 44%	HTN 22% DM 17% CVD 5% CKD 5%	In-hospital mortality
Cariou et al. [15]	10 March 2020 to 10 April 2020	53 centers across France	In-hospital patients with COVID-19 and diabetes	1317	752	70, 65%	HTN 77% DM 100% CVD 27% CKD 33%	7-Day mortality
Zhou et al. [16]	31 December 2019 to 21 April 2020	Wuhan, China	In-hospital patients with COVID-19	2718+	906	NR++	NR++	28-Day mortality
Gao et al. [17]	2 February 2020 to 15 March 2020	Wuhan, China	In-hospital patients with COVID-19	710	527	64, 52%	DM 27% CVD 21% CKD 2%	In-hospital mortality
Felice et al. [18]	9–31 March 2020	Treviso, France	Patients with COVID-19 and hypertension referred to emergency department	133	82	73, 65%	HTN 100% DM 26% CVD 60%	In-hospital mortality; severe disease
Liabeuf et al. [19]	28 February 2020 to 30 March 2020	Amiens, France	In-hospital patients with COVID-19	268	96	73, 58%	HTN 57% DM 21% CVD 12% CKD 7%	Combined endpoint of in-hospital mortality or severe disease; severe disease
Fosbol et al. [20]	1 February 2020 to 4 May 2020	Nationwide database, Denmark	Patients with COVID-19	4480	895	50–73a, 48%	HTN 19% DM 9% CVD 8% CKD 4%	In-hospital mortality; severe disease
Lopez-Otero et al. [21]	10 March 2020 to 6 April 2020	A Coruna, Spain	Patients with COVID-19	965	210	60, 44%	HTN 31% DM 13% CVD 4%	Mortality; severe disease
Selcuk et al. [22]	NR	Istanbul, Turkey	In-hospital patients with COVID-19 and hypertension	113	74	64, 59%	HTN 100% DM 36% CVD 28% CKD 10%	In-hospital mortality
Bravi et al. [23]	Til 24 April 2020	Province of Ferrara and Pescara, Italy	Patients with COVID-19 and hypertension	543	450	NR++	NR++	Combined endpoint of mortality or severe disease
Xu et al. [24]	29 December 2019 to 15 February 2020	Wuhan, China	In-hospital patients with COVID-19 and hypertension	101	40	65, 52%	HTN 100% DM 19% CVD 13% CKD 2%	In-hospital mortality
Zhang et al. [25]	NR	Wuhan, China	In-hospital patients with COVID-19 and hypertension	922b	603	67, 51%	HTN 100% DM 36% CVD 43% CKD 6%	28-Day mortality; severe disease
Dalan et al. [26]	Till 15 April 2020	National Centre of Infectious diseases, Singapore	In-hospital patients with COVID-19 and hypertension	139b	90	NR	NR	Mortality; severe disease
Shah et al. [27]	2 March 2020 to 22 May 2020	Albany, Georgia, USA	In-hospital African-American patients with COVID-19	531	207	60, 41%	HTN 80% DM 43% CVD 22% CKD 15%	In-hospital mortality; severe disease
Lam et al. [28]	7 February 2020 to 23 May 2020	New York, USA	In-hospital patients with COVID-19 and hypertension	614	335	68–73a, 55%	HTN 100% DM 41% CVD 24% CKD 15%	In-hospital mortality; severe disease
Holt et al. [41]	1 March 2020 to 1 April 2020	Denmark	In-hospital patients with COVID-19	689	225	70, 58%	NR	Combined endpoint of in-hospital mortality or severe disease
Grasselli et al. [29]	20 February 2020 to 22 April 2020	Lombardy, Italy	Critically ill COVID-19 patients admitted to ICU	3988	NR	63, 80%	HTN 41% DM 13% CVD 13% CKD 2%	In-hospital mortality
Kim et al. [30]	18 February 2020 to 31 March 2020	Daegu, South Korea	In-hospital patients with COVID-19 and diabetes	235b	70	68, 45%	HTN 63% DM 100% CVD 12% CKD 8%	In-hospital mortality
Cheung et al. [31]	1 January 2020 to 27 April 2020	Hong Kong Hospital Authority, Hong Kong	In-hospital patients with COVID-19	734	31	NR	NR	Combined endpoint of mortality or severe disease
De Spiegeleer et al. [32]	1 March 2020 to 16 April 2020	Belgium	Nursing home residents with COVID-19	154	30	86, 33%	HTN 18% DM 25%	14-Day mortality (in-hospital or nursing home)
Matsuzawa et al. [33]	1 February 2020 to 1 May 2020	Kanagawa Prefecture, Japan	In-hospital patients with COVID-19	151	22	60, 60%	HTN 26% DM 21% CVD 2% CKD 3%	In-hospital mortality; severe disease
Martínez-del Río et al. [34]	1 March 2020 to 30 April 2020	Ciudad Real, Spain	In-hospital patients with COVID-19	921	400	70, 54%	HTN 59% DM 21% CVD 16%	In-hospital mortality; severe disease
Lala et al. [35]	27 February to 12 April 2020	New York, USA	In-hospital patients with COVID-19	2736	601	66, 60%	HTN 39% DM 26% CVD 17% CKD 10%	In-hospital mortality
Imam et al. [36]	1 March 2020 to 17 April 2020	Michigan, USA	In-hospital patients with COVID-19	1305	565	61, 54%	HTN 56% DM 30% CVD 22% CKD 18%	In-hospital mortality
Ng et al. [37]	1 March 2020 to 27 April 2020	New York, USA	In-hospital patients with COVID-19	10 482	3012	66, 60%	HTN 61% DM 37% CVD 10% CKD 22%	In-hospital mortality
Gormez et al. [38]	15 March 2020 to 15 April 2020	Istanbul, Turkey	In-hospital patients with COVID-19	247	49	51, 38%	HTN 32% DM 40% CVD 10% CKD 4%	Combined endpoint of in-hospital mortality or severe disease
Díaz-Guardiola et al. [39]	NR	Madrid, Spain	In-hospital patients with COVID-19	1000	176	62, 55%	HTN 46% DM 19% CVD 16% CKD 8%	In-hospital mortality; severe disease
Trifiro et al. [40]	21 February 2020 to 21 April 2020	Lombardy, Veneto and the Reggio Emilia Local Health Unit, Italy	In-hospital patients with COVID-19	42 926	9522	69, 63	HTN 13% DM 18% CVD 17% CKD 2%	In-hospital mortality
Case–control studiesc
Mancia et al. [4]	21 February 2020 to 11 March 2020	Population-based case–control study in Lombardy region, Italy	Case: COVID-19 patients, Control: Residents ≥40 y who are beneficiaries of the Regional Health Service; Matching 1 : 5 by sex, age at index date, and municipality of residence	451 cases, 2150 matched controls	276 in cases, 1166 in controls	68, 63%	Case: CVD 30% CKD 5% Control: CVD 22% CKD 3%	Mortality
de Abajo et al. [10]	1–24 March 2020	Seven hospitals in Madrid	Case: COVID-19 patients requiring hospital admission, Control: from a Spanish primary health-care database; Matching 1 : 10 by sex and age	393 Cases, 3930 matched controls	215 In cases, 1592 in controls	69, 61%	Case: HTN 54% DM 27% CVD 11% CKD 8% Control: HTN 50% DM 20% CVD 8% CKD 5%	In-hospital mortality/severe disease
Son et al. [9]	Till 8 April 2020	Population-based case–control study in South Korea	Case: COVID-19 hypertensive patients, Control: from Korean National Health Insurance System; Matching 1 : 2 based on age, sex, region and tested hospital	38 Cases, 64 matched controls	30 In cases, 47 in controls	64, 51%	Case: DM 34% CVD 33% CKD 16% Control: DM 36% CVD 35% CKD 8%	Mortality

ACEI, angiotensin-converting enzyme inhibitors; ARB, AT1 blockers; CKD, chronic kidney disease; COVID-19, coronavirus disease 2019; CVD, cardiovascular disease; DM, diabetes mellitus; HTN, hypertension; NR, not reported.

⁺Sample size for propensity-matched analysis for ACEI/ARBs and mortality/severe disease.

⁺⁺Demographics and comorbidities specific to selected sample of COVID-19 patients used for the analysis was not available.

^aMedian age in ACEI/ARB users and nonusers.

^bSample size for ACEI/ARBs and mortality/severe disease as reported by individual study.

^cAge, sex and comorbidities data are with respect to overall sample of cases and control.