Should patients alter their use of ACEI or ARBs during the pandemic? posted on 8:48 PM, May 12, 2020
No. There is no evidence that patients taking ACEI or ARBs are at increased risk of COVID-19 infection or increased disease severity although direct comparative data is currently limited by small numbers. ACE2 enzymes are potentially upregulated by ACEI, ARBs, and NSAIDs. This enzyme also serves as a binding site for the S protein of SARS-CoV-2 virus, allowing viral entry into cells by endocytosis. Based on this fact and the identified higher mortality in COVID-19 patients with chronic conditions such as diabetes, coronary artery disease and hypertension, some have suggested that the common use of ACEI and ARBs in the treatment of these conditions – rather than the chronic medical conditions themselves – were a culprit. However, current evidence does not support this contention. Conversely, professional societies including the American College of Cariology and the American Heart Association (ACC/AHA) and the Heart Failure Society of America have recommended that patients continue their use of ACEI and ARBs in order to control their underlying hypertension and preserve the end-organ (heart, kidney) benefits that have been demonstrated with these drug classes.
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