Considerable concern has emerged for the potential harm in the use of 
angiotensin-converting enzyme inhibitors (ACEIs) and angiotensin receptor 
inhibitors (ARBs) in COVID-19 patients, given that ACEIs and ARBs may increase 
the expression of ACE2 receptors that represent the way for coronavirus 2 to 
entry into the cell and cause severe acute respiratory syndrome. Assess the 
effect of ACEI/ARBs on outcome in COVID-19 patients. Hospital-based prospective 
study. A total of 431 patients consecutively presenting at the Emergency 
Department and found to be affected by COVID-19 were assessed. Relevant clinical 
and laboratory variables were recorded, focusing on the type of current anti 
hypertensive treatment. Outcome variables were NO, MILD, SEVERE respiratory 
distress (RD) operationally defined and DEATH. Hypertension was the single most 
frequent comorbidity (221/431 = 51%). Distribution of antihypertensive treatment 
was: ACEIs 77/221 (35%), ARBs 63/221 (28%), OTHER than ACEIs or ARBs 64/221 
(29%). In 17/221 (8%) antihypertensive medication was unknown. The proportion of 
patients taking ACEIs, ARBs or OTHERs who developed MILD or SEVERE RD was 43/77 
(56%), 33/53 (52%), 39/64 (61%) and 19/77 (25%), 16/63 (25%) and 16/64 (25%), 
respectively, with no statistical difference between groups. Despite producing a 
RR for SEVERE RD of 2.59 (95% CI 1.93-3.49), hypertension was no longer 
significant in a logistic regression analysis that identified age, CRP and 
creatinine as the sole independent predictors of SEVERE RD and DEATH. ACEIs and 
ARBs do not promote a more severe outcome of COVID-19. There is no reason why 
they should be withheld in affected patients.