This study investigates the association between the use of angiotensin-receptor blockers (ARBs) and angiotensin-converting enzyme (ACE) inhibitors and the risk of coronavirus disease 2019 (Covid-19) in a large, population-based case-control study in the Lombardy region of Italy. The study matched 6,272 confirmed Covid-19 cases with 30,759 controls based on sex, age, and municipality of residence. The mean age of both groups was 68 ± 13 years, with 37% being women. The use of ARBs and ACE inhibitors was more common among case patients compared to controls, as was the use of other antihypertensive and non-antihypertensive drugs. However, after adjusting for confounders, the use of ARBs or ACE inhibitors did not show any significant association with Covid-19 infection overall or among patients with severe or fatal outcomes. The study concludes that while the use of ARBs and ACE inhibitors was more frequent among patients with Covid-19, there is no evidence that these drugs affect the risk of Covid-19.This study investigates the association between the use of angiotensin-receptor blockers (ARBs) and angiotensin-converting enzyme (ACE) inhibitors and the risk of coronavirus disease 2019 (Covid-19) in a large, population-based case-control study in the Lombardy region of Italy. The study matched 6,272 confirmed Covid-19 cases with 30,759 controls based on sex, age, and municipality of residence. The mean age of both groups was 68 ± 13 years, with 37% being women. The use of ARBs and ACE inhibitors was more common among case patients compared to controls, as was the use of other antihypertensive and non-antihypertensive drugs. However, after adjusting for confounders, the use of ARBs or ACE inhibitors did not show any significant association with Covid-19 infection overall or among patients with severe or fatal outcomes. The study concludes that while the use of ARBs and ACE inhibitors was more frequent among patients with Covid-19, there is no evidence that these drugs affect the risk of Covid-19.