To assess the associations of exposure and modifications in exposure (i.e., discontinuation on admission, initiation during hospitalization) to eight common cardiovascular therapies with the risk of in-hospital death among inpatients with coronavirus disease 2019 (COVID-19). In this observational study including 838 hospitalized unvaccinated adult patients with confirmed COVID-19, the use of cardiovascular therapies was assessed using logistic regression models adjusted for potential confounders. No cardiovascular therapy used before hospitalization was associated with an increased risk of in-hospital death. During hospitalization, the use of diuretics (aOR 2.59 1.68-3.98) was associated with an increase, and the use of agents acting on the renin-angiotensin system (aOR 0.39 0.23-0.64) and lipid-lowering agents (aOR 0.41 0.24-0.68) was associated with a reduction in the odds of in-hospital death. Exposure modifications associated with decreased survival were the discontinuation of an agent acting on the renin-angiotensin system (aOR 4.42 2.08-9.37), a β-blocker (aOR 5.44 1.16-25.46), a lipid-modifying agent (aOR 3.26 1.42-7.50) or an anticoagulant (aOR 5.85 1.25-27.27), as well as the initiation of a diuretic (aOR 5.19 2.98-9.03) or an antiarrhythmic (aOR 6.62 2.07-21.15). Exposure modification associated with improved survival was the initiation of an agent acting on the renin-angiotensin system (aOR 0.17 0.03-0.82). In hospitalized and unvaccinated patients with COVID-19, there was no detrimental association of the prehospital use of any regular cardiovascular medication with in-hospital death, and these therapies should be continued as recommended.