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Manica et al. conducted a population-based case-control study in the Lombardy region of Italy. The aim of this study was to identify association of the

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Manica et al. conducted a population-based case-control study in the Lombardy region of Italy. The aim of this study was to identify association of the use of angiotensin-receptor blockers (ARBS) and angiotensin- converting-enzyme (ACE) inhibitors with the risk of COVID-19. A total of 6272 case patients in whom infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) was confirmed between February 21 and March 11, 2020, were matched to 30,759 beneficiaries of the Regional Health Service (controls) according to sex, age, and municipality of residence. Information about the use of selected drugs and patients' clinical profiles was obtained from regional databases of health care use. The table below describes demographic and clinical characteristics of patients with COVID-19 and controls. Reference: Mancia, G., Rea, F., Ludergnani, M., Apolone, G., & Corrao, G. (2020). Renin-Angiotensin-Aldosteronismem Blockers and the Risk of Covid-19. New England Journal of Medicine, 382(25), 2431-2440. doi:10.1056/NEJMoa2006923 Table 1. Demographic and Clinical Characteristics of Patients with Covid-19 (Case Patients) and Matched Controls Characteristics Case patients (N=6,272) Controls (N=30,759) Relative Difference (%) Coexisting conditions and associated procedures Cardiovascular disease 1,891 (30.1) 6,679 (21.7) 28.0 Coronary artery disease 473 (7.5) 1,519 (4.9) 34.6 Heart failure 323 (5.1) 759 (2.5) 52.1 Respiratory disease 651 (10.4) 1,716 (5.6) 46.3 Chronic obstructive pulmonary disease 188 (3.0) 433 (1.4) 53.1 Asthma 18 (0.3) 35 (0.1) 60.4 Kidney disease 311 (5.0) 818 (2.7) 26.8 Cancer 1,091 (17.4) 4,639 (15.1) 13.3 Which of the following is true based on the data presented in the table and your understanding of the case-control study design? O A. Asthma was more common among controls O B. Most controls do not have confirmed diagnosis of COVID-19 O C. Patients with a confirmed diagnosis of COVID-19 were more likely to develop coronary artery disease O D. The possible association of heart failure with COVID-19 in this study is less likely due to the difference in the age distribution between cases and controls

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