key: cord-1010339-75sz4mt6 authors: Zhou, Jiandong; Tse, Gary; Lee, Sharen; Liu, Tong; Cao, Zhidong; Zeng, Daniel Dajun; Leung, Keith Sai Kit; Wai, Abraham Ka Chung; Wong, Ian Chi Kei; Cheung, Bernard Man Yung; Zhang, Qingpeng title: Interaction effects between angiotensin‐converting enzyme inhibitors or angiotensin receptor blockers and steroid or antiviral therapies in COVID‐19: A population‐based study date: 2021-03-09 journal: J Med Virol DOI: 10.1002/jmv.26904 sha: a198230a59cf754a8aefc97d6fd4a8139131501b doc_id: 1010339 cord_uid: 75sz4mt6 We read the recent article published in your journal on the predictors of mortality in patients with coronavirus 2019 (COVID-19) infection with great interest 1 . This article is protected by copyright. All rights reserved. before and after propensity score matching for baseline demographics, past medical comorbidities and medication history are shown in Tables S3 and S4, respectively. The results of the univariate regression analysis on the matched cohorts are shown in Table S5 . Increasing age, higher Charlson comorbidity score, and the use of medications such as steroids, diuretics for heart failure, antidiabetic drugs, proton pump inhibitors, anticoagulants, low albumin, and the presence of acidosis were significantly associated with higher odds of meeting the primary outcome in both cohorts. Although ACEI and ARB use was significantly associated with higher odds of meeting the primary outcome, the application of propensity score matching analysis revealed a greater comorbidity burden to be the likely explanation. Thus, before matching, the percentage of patients meeting the composite outcome was 19.78% for ACEI users and 4.62% for non-users (p < .0001). The gap between these percentages was smaller after matching, to the extent that they were no longer statistically significantly different from each other (19.78% vs. 14.28%, p = .4175). Similarly, for ARB users and non-users, these percentages were 10.57% and 5.26% before matching (p = .0635), and the gap was reduced after matching to 10.57% and 16.82% (p = .2678). Interaction effects between ACEIs, ARBs, and individual drugs in these classes with antiviral therapies or steroids were assessed in the unmatched cohort ( The authors declare that there are no conflict of interests. The peer review history for this article is available at https://publons. com/publon/10.1002/jmv.26904. The data that support the findings of this study are available from the corresponding author upon reasonable request. APTT, s 30 Predictors of mortality in 217 COVID-19 patients in Northwest Ohio, United States: a retrospective study Impact of corticosteroids in coronavirus disease 2019 outcomes: systematic review and metaanalysis ACE inhibitors and angiotensin II receptor blockers may have different impact on prognosis of COVID-19 The controversy of using angiotensin-converting enzyme inhibitors and angiotensin receptor blockers in COVID-19 patients ACEi and ARB with COVID-19 ACE inhibitors and COVID-19: we don't know yet Impact of cardiovascular disease and cardiac injury on in-hospital mortality in patients with COVID-19: a systematic review and meta-analysis 2019-Novel coronavirus-related acute cardiac injury cannot be ignored Proton pump inhibitor or famotidine use and severe COVID-19 disease: a propensity score-matched territory-wide study Anticoagulant or antiplatelet use and severe COVID-19 disease: A propensity score-matched territorywide study Obesity and COVID-19: 2 The ominous duet affecting the renin-angiotensin system The immune-modulatory effects of exercise should be favorably harnessed against COVID-19