Conclusion
There appears to be no evidence of association between ACEIs/ARBs use and a wide range of COVID-19 related clinical outcomes. However, good quality evidence exists for ACEIs/ARBs and higher odds of hospitalisation, lower odds of death/ICU admission (as composite endpoint); but low-quality evidence for higher ICU admission, ventilator use, hospital discharge and lower duration of hospital stay. Furthermore, there are evidence, albeit of poor quality, of differences between ACEIs and ARBs with the latter being associated with significantly higher ICU admission but lower COVID-19 infection risk and severity. Given the continuing controversial and paradoxical clinical studies’ findings and hypotheses, we believe it is necessary to continue to evaluate the effects of ACEIs/ARBs on COVID-19 clinical outcomes especially as more randomised studies are reported.