Key result
Continuing RAS blockers during COVID-19 infection remains scientifically justified despite ACE2 expression concerns.
Why the study?
Because ACE2 serves as a receptor for SARS-CoV-2 and is upregulated by RAS blockers, concerns arose regarding possible detrimental effects of these drugs on COVID-19 pathogenesis and cardiovascular complications.
Should renin-angiotensin system (RAS) blockers be continued in patients with COVID-19 infection?
Should renin-angiotensin system (RAS) blockers be continued in patients with COVID-19 infection?
This review provides a scientific rationale supporting the continuation of RAS blockers in patients with COVID-19, countering theoretical concerns about ACE2 upregulation.
RAS blocker-induced ACE2 upregulation raises COVID-19 concerns; leaves open whether to alter therapy pending clinical data.
Renin-angiotensin system (RAS) blockers are extensively used worldwide to treat many cardiovascular disorders, where they are effective in reducing both mortality and morbidity. These drugs are known to induce an increased expression of angiotensin-converting enzyme 2 (ACE2). ACE2 acts as receptor for the novel SARS coronavirus-2 (SARS-CoV-2) which raising the important issue of possible detrimental effects that RAS blockers could exert on the natural history and pathogenesis of the coronavirus disease-19 (COVID-19) and associated excessive inflammation, myocarditis and cardiac arrhythmias. We review the current knowledge on the interaction between SARS-CoV-2 infection and RAS blockers and suggest a scientific rationale for continuing RAS blockers therapy in patients with COVID-19 infection.
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Aleksova et al. (2020) conducted a review in COVID-19 and cardiovascular disorders. Renin-angiotensin system (RAS) blockers was evaluated. There is a scientific rationale for continuing renin-angiotensin system (RAS) blockers therapy in patients with COVID-19 infection despite concerns regarding ACE2 expression.
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