ACE-inhibitors and ARBs in COVID-19: a review of the evidence


  • Dawn O'Shea
  • Univadis Medical News
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Recent concerns that common antihypertensive drugs may have a negative effect in COVID-19 patients are not supported by the evidence, report scientists in a new review published in Mayo Clinic Proceedings

There has been considerable debate regarding the possible relationship between the renin-angiotensin-aldosterone system and the SARS-CoV-2 virus, with some suggesting angiotensin-converting enzyme (ACE) inhibitors (ACEIs) and angiotensin receptor blockers (ARBs) could worsen COVID-19 infection.

This review of more than 60 published studies concluded that no studies have reported an increase in circulating ACE2 levels or expression.

Because of their role in controlling blood pressure, the findings suggest ARBs and ACEIs may improve prognosis in COVID-19 hypertensive patients. The authors concluded that patients should continue treatment with ACEIs and ARBS.

They say, because no differences generally exist between ARBs and ACEIs in terms of efficacy, given that ACEIs are associated with more treatment discontinuations due to adverse events, ARBs could potentially be a more favourable treatment option in COVID-19 patients at higher risk of developing severe forms of disease.