Incidence rates of COVID-19 diagnosis were 85.63/1,000 person-years amongst alpha-1 blockers, and 108.25/1,000 among 5ARI/PDE5 users in SIDIAP; 8.96 vs. 7.97/1,000 in VA; 5.62 vs. 4.78/1,000 in OpenClaims; 3.40 vs. 4.89/1,000 in Optum DOD; and 38.88 vs. 47.08/1,000 in Optum EHR. Here, PDE5A is linked to COVID-19.