<h4>Objective</h4>To determine the effect of angiotensin-converting enzyme inhibitors (ACEIs) and angiotensin receptor blockers (ARBs) use prior to hospitalization on clinical outcomes in coronavirus disease 2019 (COVID-19) patients.<h4>Design</h4>An observational retrospective cohort study from 178 hospitals from a large health system across the United States.  Patient population: Hospitalized patients (n=2726) with confirmed COVID-19 between January 1, 2020, and April 1, 2020. The gene discussed is ACE; the disease is COVID-19.