These medications provide known benefits to patients who need them, while potential harms remain unproven.
Experts in the renin-angiotensin-aldosterone system (RAAS) have provided a useful special report summarizing the evidence about the use of RAAS inhibitors, such as angiotensin-converting–enzyme (ACE) inhibitors and angiotensin-receptor blockers (ARBs), in patients with COVID-19.
SARS-CoV-2, the virus that causes COVID-19, enters cells by binding to ACE2 as a receptor. ACE2 counters RAAS activation, primarily by degrading angiotensin II to angiotensin-(1–7), reducing angiotensin II's effects on vasoconstriction, sodium retention, and fibrosis. Some preclinical studies indicated that RAAS inhibitors may increase the expression of ACE2, raising concerns that these medications could increase susceptibility to infection. Nevertheless, whether ACE…
Reviewing Author
DisclosuresConsultant/Advisory BoardUnited Healthcare; Element Science; Eyedentifeye, F-Prime
EquityHugo Health; Refactor Health; Element Science
Grant/Research SupportPfizer; Agency for Healthcare Research and Quality; Janssen Research and Development, National Institute of Biomedical Imaging and Engineering; National Heart, Lung, and Blood Institute; Centers for Disease Control and Prevention; National Cancer Institute; American Heart Association
DisclosuresConsultant/Advisory BoardUnited Healthcare; Element Science; Eyedentifeye, F-Prime
EquityHugo Health; Refactor Health; Element Science
Grant/Research SupportPfizer; Agency for Healthcare Research and Quality; Janssen Research and Development, National Institute of Biomedical Imaging and Engineering; National Heart, Lung, and Blood Institute; Centers for Disease Control and Prevention; National Cancer Institute; American Heart Association