Associations Between Angiotensin-Converting Enzyme Inhibitors and Angiotensin II Receptor Blocker Use, Gastrointestinal Symptoms, and Mortality Among Patients With COVID-19

The gastrointestinal (GI) tract and liver represent common target organs of coronavirus disease 2019 (COVID-19).1 A recent meta-analysis showed that 17.6% of patients with COVID-19 had gastrointestinal symptoms.2 Digestive system involvement is associated with a poor disease course.(3) Angiotensin-converting enzyme inhibitors (ACEI) and angiotensin receptor blockers (ARB) are commonly used in patients with hypertension. A recent landmark study including 1128 patients with COVID-19 with hypertension showed that inpatient use of ACEI/ARB was associated with lower risk of mortality compared with ACEI/ARB nonusers.4 We aimed to determine the impact of ACEI/ARB use on the digestive system in patients with COVID-19 with hypertension.