The concern about ACE/ARB and COVID-19: Time to hold your horses!

J Am Pharm Assoc (2003). 2020 Nov-Dec;60(6):e88-e90. doi: 10.1016/j.japh.2020.06.026. Epub 2020 Jul 31.

Abstract

Concern about coronavirus 2019 (COVID-19) morbidity and mortality has drawn attention to the potential role of angiotensin-converting enzyme (ACE) inhibitors and angiotensin-receptor blockers (ARBs) because the SARS-CoV-2 uses the ACE2 receptor as its point of entry into the body. It is not clear if and to what degree the SARS-CoV-2 virus affects the renin-angoiotensin system. Early studies from China which speculated on the role of ACE inhibition and ARBs did not evaluate the drug regimens. A vast body of evidence supports the use of ACE inhibitors and ARBs in hypertensive patients and patients with heart failure, and very little evidence has been acquired about their role in COVID-19. There is good evidence in support of the use of ACE inhibitors and ARBs in indicated patients with hypertension and heart failure, and clinicians should be reticent about abruptly withdrawing these drugs based on a paucity of evidence.

MeSH terms

  • Angiotensin Receptor Antagonists / administration & dosage
  • Angiotensin Receptor Antagonists / therapeutic use*
  • Angiotensin-Converting Enzyme 2 / genetics
  • Angiotensin-Converting Enzyme 2 / metabolism*
  • Angiotensin-Converting Enzyme Inhibitors / administration & dosage
  • Angiotensin-Converting Enzyme Inhibitors / therapeutic use*
  • Animals
  • COVID-19 / virology
  • COVID-19 Drug Treatment*
  • Heart Failure / drug therapy*
  • Heart Failure / metabolism
  • Humans
  • Hypertension / drug therapy*
  • Hypertension / metabolism
  • Renin-Angiotensin System / drug effects
  • SARS-CoV-2

Substances

  • Angiotensin Receptor Antagonists
  • Angiotensin-Converting Enzyme Inhibitors
  • ACE2 protein, human
  • Angiotensin-Converting Enzyme 2