Targeting the renin-angiotensin system is proposed to affect mortality due to 
coronavirus disease 2019 (COVID-19). We aimed to compare the mortality rates in 
COVID-19 patients who received angiotensin-converting enzyme inhibitors or 
angiotensin receptor blockers (ACEIs/ARBs) and those who did not. In this 
retrospective cohort study, mortality was considered as the main outcome 
measure. All underlying diseases were assessed by the chronic use of medications 
related to each condition. We defined two main groups based on the ACEIs/ARBs 
administration. A logistic regression model was designed to define independent 
predictors of mortality as well as a Cox regression analysis. In total, 2553 
patients were included in this study. The mortality frequency was higher in 
patients with a history of underlying diseases (22.4% vs 12.7%, P 
value < 0.001). The mortality rate in patients who received ACEIs/ARBs were 
higher than non-receivers (29.3% vs. 19.5%, P value = 0.013, OR = 1.3, 95% CI 
1.1, 1.7) in the univariate analysis. However, the use of ACEIs/ARBs was a 
protective factor against mortality in the model when adjusted for underlying 
conditions, length of stay, age, gender, and ICU admission (P value < 0.001, 
OR = 0.5, 95% CI 0.3, 0.7). The Kaplan-Meier curve showed an overall survival of 
approximately 85.7% after a 120-day follow-up. ACEIs/ARBs are protective factors 
against mortality in COVID-19 patients with HTN, and these agents can be 
considered potential therapeutic options in this disease. The survival 
probability is higher in ACEIs/ARBs receivers than non-receivers.