Tehran University of Medical Sciences Frontiers in Emergency Medicine 2717-3593 6 3 2022 02 22 e34 e34 Mohammad-Mehdi Mehrabi Nejad Department of Radiology, School of Medicine, AJA University of Medical Science, Tehran, Iran Hamed Bagheri Student Research Committee, AJA University of Medical Sciences, Tehran, Iran Seyyed Hosein Mousavi Department of Cardiology, School of Medicine, AJA University of Medical Sciences, Tehran, Iran Faeze Salahshour Advanced Diagnostic and Interventional Radiology Research Center (ADIR), Tehran University of Medical Sciences, Tehran, Iran Niloofar Ayoobi Yazdi Advanced Diagnostic and Interventional Radiology Research Center (ADIR), Tehran University of Medical Sciences, Tehran, Iran Babak Shekarchi Department of Radiology, School of Medicine, AJA University of Medical Science, Tehran, Iran 2021 12 28 2022 01 26 Objective: We aimed to investigate the extent of pulmonary involvement and adverse outcomes in patients receiving angiotensin-converting enzyme inhibitor (ACEI)/ angiotensin II receptor blocker (ARB) versus who did not, in hospitalized coronavirus infectious disease 2019 (COVID-19) patients. Methods: All COVID-19 patients with a positive polymerase chain reaction (PCR) test, who were admitted to our tertiary referral hospitals in Tehran, Iran between January 2021 and May 2021, and had an on-admission chest computed tomography (CT) scan, were included. The patients were divided into two groups (receiving ACEI/ARB and who did not) for further analysis. The outcomes of interest in our study were the extent of pulmonary involvement, intensive care unit (ICU) admission, and death. Results: A total of 893 participants (mean age of 58.6±15.4 years; female, 522 (58.4%)) were enrolled. Among them, 368 (41.2%) participants had hypertension, and use of ACEI/ARB was reported in 183 (20.5%) participants. Of all, 409 (45.8%) participants required ICU admission, and 259 (29%) participants succumbed to death. We found that participants who received ACEI/ARB were less likely to progress critical disease and experienced significantly lower ICU admission (P=0.022) and death (P<0.001). On multivariable analysis adjusting for age, sex, and comorbidities, this relationship remained statistically significant for death [OR: 0.23 (0.14-0.38); P<0.001] and ICU admission [OR: 0.49 (0.32-0.73); P=0.001]. Conclusion: Our findings showed that COVID-19 patients who receiving ACEI/ARB prior to hospitalization vs. those who did not, had more favorable outcomes. https://fem.tums.ac.ir/index.php/fem/article/view/926 https://fem.tums.ac.ir/index.php/fem/article/download/926/393