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Use of ACEI and ARB meds and COVID-19 confirmed cases and death rate: geospatial analysis

Our manuscript is published in the American Journal of Cardiology. We tested the hypothesis that the rate of angiotensin-converting enzyme inhibitor (ACEI) and angiotensin receptor blocker (ARB) use is associated with the rate of COVID-19–confirmed cases and deaths. We conducted a geospatial, ecological study using publicly available county-level data. The Medicare ACEI and ARB prescription rate was exposure. The COVID-19–confirmed case and death rates were outcomes. We ran analyses three times, at different time points during the pandemic, which were made available as preprints. Notably, analyses conduced at 3 different time points used different data that were available, which explains different conclusions in several versions of the manuscript. Our final published analysis showed that in this ecological study, ACEI and ARB use rates were not associated with COVID-19 infectivity and death rate. Our findings support the safety of ACEI and ARB use in patients with CVD in the COVID-19 era. Significant ecological association of numerous socioeconomic characteristics of counties with COVID-19–confirmed case rates underscores the importance of public health policies to minimize the impact of COVID-19 on socioeconomically disadvantaged neighborhoods.

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