Introduction: Corona Virus disease 2019 (COVID-19) caused by the Severe Acute 
Respiratory Syndrome coronavirus 2 (SARS-CoV-2) has become a global pandemic. 
The aim of this study was to investigate the impact of being on an 
Angiotensin-Converting Enzyme Inhibitors (ACEI) and/or Angiotensin Receptor 
Blockers (ARB) on hospital admission, on the following COVID-19 outcomes: 
disease severity, ICU admission, and mortality. Methods: The charts of all 
patients consecutively diagnosed with COVID-19 from the 24th of February to the 
16th of June of the year 2020 in Jaber Al-Ahmed Al-Sabah hospital in Kuwait were 
checked. All related patient information and clinical data was retrieved from 
the hospitals electronic medical record system. The primary outcome was COVID-19 
disease severity defined as the need for Intensive Care Unit (ICU) admission. 
Secondary outcome was mortality. Results: A total of 4,019 COVID-19 patients 
were included, of which 325 patients (8.1%) used ACEI/ARB, users of ACEI/ARB 
were found to be significantly older (54.4 vs. 40.5 years). ACEI/ARB users were 
found to have more co-morbidities; diabetes (45.8 vs. 14.8%) and hypertension 
(92.9 vs. 13.0%). ACEI/ARB use was found to be significantly associated with 
greater risk of ICU admission in the unadjusted analysis [OR, 1.51 (95% CI: 
1.04-2.19), p = 0.028]. After adjustment for age, gender, nationality, coronary 
artery disease, diabetes and hypertension, ICU admission was found to be 
inversely associated with ACEI use [OR, 0.57 (95% CI: 0.34-0.88), p = 0.01] and 
inversely associated with mortality [OR, 0.56 (95% CI: 0.33-0.95), p = 0.032]. 
Conclusion: The current evidence in the literature supports continuation of 
ACEI/ARB medications for patients with co-morbidities that acquire COVID-19 
infection. Although, the protective effects of such medications on COVID-19 
disease severity and mortality remain unclear, the findings of the present study 
support the use of ACEI/ARB medication.