¿Tienen mayor riesgo frente al COVID-19 los pacientes que toman inhibidores de la enzima convertidora de angiotensina (IECA)

(Are patients taking angiotensin-converting enzyme inhibitors (ace) at increased risk for covid-19?)

Primeras 5 respuestas:

angiotensin-converting enzyme (ACE) inhibitors and angiotensin receptor blockers (ARBs) increase the expression of ACE2.

Many of them are treating with angiotensin-converting enzyme inhibitor (ACEI) or angiotensin II receptor blocker (ARB)[8].

Discontinuing these medications in COVID-19 patients may therefore potentially be harmful.

One hundred twenty-five age- and sex-matched patients with COVID-19 without hypertension were randomly selected as nonhypertension controls.

There are conflicting data on the effect of RAAS inhibitors in COVID-19 patients [9, 13, 29] .

angiotensin-converting enzyme (ACE) inhibitors and angiotensin receptor blockers (ARBs) increase the expression of ACE2.

... the renin-angiotensin-aldosterone system in patients with COVID-19. Animal data and human studies have shown that angiotensin-converting enzyme (ACE) inhibitors and angiotensin receptor blockers (ARBs) increase the expression of ACE2. ACE2 is an enzyme found in the heart, kidney, gastrointestinal tract, and lung and is ...

Ref: cord_uid tw6968h3 ACE Inhibitors and ARBs in Patients with COVID... tw6968h3 Angiotensin-Converting Enzyme Inhibitors and A... Name: title, dtype: object [Eur J Nucl Med Mol Imaging, cord_uid tw6968h3 2020-05-15 tw6968h3 2020 Name: publish_time, dtype: object]

Many of them are treating with angiotensin-converting enzyme inhibitor (ACEI) or angiotensin II receptor blocker (ARB)[8].

... patients belong to cardiovascular comorbidities [8-10]. It is obvious that they qualify for antihypertensive therapy. Many of them are treating with angiotensin-converting enzyme inhibitor (ACEI) or angiotensin II receptor blocker (ARB)[8]. There has been considerable debate in scientific community and health professionals about whether angiotensin converting ...

Ref: A Viewpoint on Angiotensin-Converting Enzyme 2, Anti-Hypertensives and Coronavirus Disease 2019 (COVID-19). [Infectious disorders drug targets, 2020-05-10]

Discontinuing these medications in COVID-19 patients may therefore potentially be harmful.

... SARS-CoV-2. This could be achieved by administering recombinant soluble ACE-2. We also discuss why and how ACEIs and ARBs provide cardiovascular, renal and also pulmonary protection in SARS-CoV-2- associated ARDS. Discontinuing these medications in COVID-19 patients may therefore potentially be harmful. ...

Ref: Potential harmful effects of discontinuing ACE-inhibitors and ARBs in COVID-19 patients [eLife (Cambridge), 2020]

One hundred twenty-five age- and sex-matched patients with COVID-19 without hypertension were randomly selected as nonhypertension controls.

... to ARBs/ACE inhibitors group (n=43) and non-ARBs/ACE inhibitors group (n=83) according to their antihypertensive medication. One hundred twenty-five age- and sex-matched patients with COVID-19 without hypertension were randomly selected as nonhypertension controls. In addition, the medication history of 1942 patients with hypertension that were admitted to Hubei ...

Ref: Effects of Angiotensin II Receptor Blockers and ACE (Angiotensin-Converting Enzyme) Inhibitors on Virus Infection, Inflammatory Status, and Clinical Outcomes in Patients With COVID-19 and Hypertension: A Single-Center Retrospective Study [Hypertension, 2020]

There are conflicting data on the effect of RAAS inhibitors in COVID-19 patients [9, 13, 29] .

... is using angiotensin-converting-enzyme 2 (ACE2) for binding to the surface of epithelial cells [28] . There are conflicting data on the effect of RAAS inhibitors in COVID-19 patients [9, 13, 29] . However, it seems that first studies about the adverse impact of RAAS inhibitors were premature ...

Ref: cord_uid bwkad2s0 COVID-19, hypertension and cardiovascular dise... bwkad2s0 COVID-19, hypertension and cardiovascular dise... Name: title, dtype: object [Hypertension, cord_uid bwkad2s0 2020-05-13 bwkad2s0 2020-05-13 Name: publish_time, dtype: object]

Many of those patients are treated with renin-angiotensin system blockers.

... of COVID-19. This includes patients with hypertension, heart disease, diabetes mellitus, and clearly the elderly. Many of those patients are treated with renin-angiotensin system blockers. Because the ACE2 (angiotensin-converting enzyme 2) protein is the receptor that facilitates coronavirus entry into ...

Ref: Renin-Angiotensin System Blockers and the COVID-19 Pandemic: At Present There Is No Evidence to Abandon Renin-Angiotensin System Blockers [Hypertension, 2020-03-25]

This study was designed to investigate any difference in disease severity between COVID-19 patients with hypertension comorbidity.

... (ACEI) and Angiotensin II receptor blocker (ARB) shall be continued in the confirmed COVID-19 patients. This study was designed to investigate any difference in disease severity between COVID-19 patients with hypertension comorbidity. The included COVID-19 patients used ACEI, ARB, calcium channel blockers (CCB), beta blockers (BB), or ...

Ref: Anti-hypertensive Angiotensin II receptor blockers associated to mitigation of disease severity in elderly COVID-19 patients [Hypertension, 2020-03-27]

the discontinuation of these medications is unjustified and could result in more negative outcomes.

... Pending more research on this topic, and lacking evidence of harm to patients infected by COVID-19 while taking ACEIs and ARBs, the discontinuation of these medications is unjustified and could result in more negative outcomes. ...

Ref: Angiotensin-Converting Enzyme 2 and the Resolution of Inflammation: In Support of Continuation of Prescribed Angiotensin-Converting Enzyme Inhibitors and Angiotensin-Receptor Blockers [Mayo Clin Proc, 2020-05-21]

Patients who take ACEIs and ARBS may be at increased risk of severe disease outcomes due to SARS-CoV-2 infections.

... blockers (ARBs) in experimental animals increase the numbers of angiotensin-converting enzyme 2 (ACE2) receptors in the cardiopulmonary circulation. ACE2 receptors serve as binding sites for SARS-CoV-2 virions in the lungs. Patients who take ACEIs and ARBS may be at increased risk of severe disease outcomes due to SARS-CoV-2 infections. ...

Ref: Hypothesis: angiotensin-converting enzyme inhibitors and angiotensin receptor blockers may increase the risk of severe COVID-19 [J Travel Med, 2020-03-23]

Many high-risk COVID-19 patients with comorbidities are on ACE inhibitors and angiotensin receptor blockers,

... a number of associated comorbidities have been identified as risk factors for infection with COVID-19. Many high-risk COVID-19 patients with comorbidities are on ACE inhibitors and angiotensin receptor blockers, and this has sparked debate about whether to continue these treatment regimes. Attention has also ...

Ref: Coronavirus disease 2019 (COVID-19) and the renin-angiotensin system: A closer look at angiotensin-converting enzyme 2 (ACE2) [Ann Clin Biochem, 2020-06-02]

The effects of ACE2 are not suppressed by ACE inhibitors (ACEIs) [7] .

... through the Mas receptor [7] . ACE2 also cleaves angiotensin I to angiotensin-(1-9) [7] . The effects of ACE2 are not suppressed by ACE inhibitors (ACEIs) [7] . Under normal physiological conditions, activities of the ACE/Ang II/AT 1 R axis, ACE/ Ang II/AT ...

Ref: Potential differential effects of renin-angiotensin system inhibitors on SARS-CoV-2 infection and lung injury in COVID-19 [Hypertens Res, 2020-05-20]

ACE inhibitors (ACEIs) do not affect its activity.

... site, and it has 40% homology with ACE. It is an ectoenzyme with its N-terminus and catalytic site facing the extracellular space so it can metabolize circulating peptides (29) . ACE inhibitors (ACEIs) do not affect its activity. ...

Ref: The Lung, the Heart, the Novel Coronavirus, and the Renin-Angiotensin System; The Need for Clinical Trials [Front Med (Lausanne), 2020-05-22]

There have been some concerns about the use of Angiotensin Converting Enzyme (ACE) inhibitors and Angiotensin Receptor Blockers (ARBs),

... special concerns while managing patients with diabetes in the times of COVID-19 pandemic [11] . There have been some concerns about the use of Angiotensin Converting Enzyme (ACE) inhibitors and Angiotensin Receptor Blockers (ARBs), which were not clarified in our publication [12] . We are summarising the current evidence ...

Ref: Clinical considerations for patients with diabetes in times of COVID-19 pandemic [Diabetes Metab Syndr, 2020-03-16]

We conclude that patients being treated with ACEIs and ARBs should continue their use for approved indications.

... not increase ACE2 expression. Available evidence, in particular, data from human studies, does not support the hypothesis that ACEI/ARB use increases ACE2 expression and the risk of complications from COVID-19. We conclude that patients being treated with ACEIs and ARBs should continue their use for approved indications. ...

Ref: Risks of ACE Inhibitor and ARB Usage in COVID-19: Evaluating the Evidence [Clin. pharmacol. ther, 2020]

there are conflicting results with the use of angiotensin converting enzyme (ACE) inhibitors and angiotensin receptor blockers (ARB) in these patients.

... acute respiratory syndrome coronavirus 2 (SARS CoV-2), and the role of ACE2 in lung injury; there are conflicting results with the use of angiotensin converting enzyme (ACE) inhibitors and angiotensin receptor blockers (ARB) in these patients. Management of patients with diabetes in times of restrictions on mobility poses some challenges and ...

Ref: Diabetes and COVID-19: evidence, current status and unanswered research questions [Eur J Clin Nutr, 2020]

Older COVID-19-affected patients with cardiovascular comorbidities exhibit a more severe clinical course and a worse prognosis,

... the most prevalent comorbidities in deceased patients with COVID-19 are hypertension, diabetes and cardiovascular diseases. Older COVID-19-affected patients with cardiovascular comorbidities exhibit a more severe clinical course and a worse prognosis, with many of them being also treated with ARBs or ACE-Is. Another confounding factor is ...

Ref: The SARS-CoV-2 receptor, ACE-2, is expressed on many different cell types: implications for ACE-inhibitor- and angiotensin II receptor blocker-based cardiovascular therapies [Intern. emerg. med, 2020]

Some Authors recently suggested that angiotensin-converting enzyme (ACE) inhibitors and angiotensin II receptor blockers (ARBs) should be discontinued,

... Some Authors recently suggested that angiotensin-converting enzyme (ACE) inhibitors and angiotensin II receptor blockers (ARBs) should be discontinued, even temporarily, given the current pandemic of SARS-CoV-2 virus. The suggestion is based on the hypothesis that ACE-inhibitors and ARBs may favor the entry and diffusion of SARS-CoV-2 virus into ...

Ref: ACE-inibitori, sartani e sindrome respiratoria acuta da coronavirus 2./ [ACE-inhibitors, angiotensin receptor blockers and severe acute respiratory syndrome caused by coronavirus] [G Ital Cardiol (Rome), 2020]

Higher ACE2 concentrations might lead to increased vulnerability to SARS-CoV-2 in patients on RAAS inhibitors.

... of renin-angiotensin-aldosterone system (RAAS) inhibitors. Angiotensin-converting enzyme 2 (ACE2) is a functional receptor for coronaviruses. Higher ACE2 concentrations might lead to increased vulnerability to SARS-CoV-2 in patients on RAAS inhibitors. METHODS AND RESULTS: We measured ACE2 concentrations in 1485 men and 537 women with heart ...

Ref: Circulating plasma concentrations of angiotensin-converting enzyme 2 in men and women with heart failure and effects of renin-angiotensin-aldosterone inhibitors [Eur Heart J, 2020]

administering ARBs or ACEIs might increase the risk of developing severe and fatal COVID-19.

... It has been hypothesized that increased levels of ACE2 may facilitate COVID-19 infection, such that administering ARBs or ACEIs might increase the risk of developing severe and fatal COVID-19. [24] [25] [26] As discussed later in this section, this premise is based in part ...

Ref: Angiotensin-Converting Enzyme 2 and Antihypertensives (Angiotensin Receptor Blockers and Angiotensin-Converting Enzyme Inhibitors) in Coronavirus Disease 2019 [Mayo Clin Proc, 2020-04-04]

Recent data show the lack of untoward effects of ACE inhibitors or angiotensin receptor blockers for COVID-19 infection and severity.

... to COVID-19 but may be also protective versus angiotensin II mediated vasoconstriction and inflammatory activation. Recent data show the lack of untoward effects of ACE inhibitors or angiotensin receptor blockers for COVID-19 infection and severity. Prospective trials are needed to ascertain whether these drugs may have protective effects. This article ...

Ref: COVID 19 and heart failure: from infection to inflammation and angiotensin II stimulation. Searching for evidence from a new disease [Eur. j. heart fail, 2020]

Mortality statistics suggest that COVID-19 is more lethal in aged patients with comorbid conditions including hypertension.

... COVID-19 has recently become a major pandemic with associated socioeconomic dimensions. Mortality statistics suggest that COVID-19 is more lethal in aged patients with comorbid conditions including hypertension. There is ongoing debate about whether the use of angiotensin converting enzyme (ACE) inhibitors (ACEi) and angiotensin receptor blockers ...

Ref: Review of evidence on using ACEi and ARBs in patients with hypertension and COVID-19 [Drugs Ther Perspect, 2020-06-09]

The plasma concentration of angiotensin does rise substantially in severe COVID-19 infections [19] .

... ACE2 is accompanied by accumulation of angiotensin, its substrate, in the lung, with adverse effects. The plasma concentration of angiotensin does rise substantially in severe COVID-19 infections [19] . There is a body of experimental and clinical evidence, mentioned above, that renin-angiotensin block, by ...

Ref: Response to four comments on ‘Can angiotensin receptor-blocking drugs perhaps be harmful in the COVID-19 pandemic?’ [J Hypertens, 2020-05-06]

ARBs could potentially be a more favorable treatment option in patients with COVID-19 at higher risk for severe forms of disease.

... are associated with cough secondary to accumulation of bradykinin and angioedema, and withdrawal rates due to adverse events are lower with ARBs. Given their equal efficacy but fewer adverse events, ARBs could potentially be a more favorable treatment option in patients with COVID-19 at higher risk for severe forms of disease. ...

Ref: Angiotensin-Converting Enzyme 2 and Antihypertensives (Angiotensin Receptor Blockers and Angiotensin-Converting Enzyme Inhibitors) in Coronavirus Disease 2019 [Mayo Clin Proc, 2020]

children are at decreased risk of severe COVID-19.

... 2/Ang-(1-7) pathway and the potential differences between adults and children, it is crucial that children are included in coronavirus-related research, as this may shed light on potential mechanisms for why children are at decreased risk of severe COVID-19. ...

Ref: ACE2 (Angiotensin-Converting Enzyme 2), COVID-19, and ACE Inhibitor and Ang II (Angiotensin II) Receptor Blocker Use During the Pandemic: The Pediatric Perspective [Hypertension, 2020]

Neither ACE inhibitors nor ARBs were associated with an increased risk of in-hospital death.

... with an increased risk of inhospital death. Female sex was associated with a decreased risk. Neither ACE inhibitors nor ARBs were associated with an increased risk of in-hospital death. A secondary analysis that was restricted to patients with hypertension (those for whom an ACE ...

Ref: Inhibitors of the Renin–Angiotensin–Aldosterone System and Covid-19 [N Engl J Med, 2020-05-01]

Angiotensin-converting enzyme (ACE) and its homologue, ACE2, have been mostly associated with hypertensive disorder.

... Angiotensin-converting enzyme (ACE) and its homologue, ACE2, have been mostly associated with hypertensive disorder. However, recent pandemia of SARS-CoV-2 has put these proteins at the center of attention, as this virus has been shown to exploit ACE2 protein to enter cells. Clear difference in ...

Ref: Angiotensin converting enzyme: A review on expression profile and its association with human disorders with special focus on SARS-CoV-2 infection [Vascul Pharmacol, 2020-05-11]

As two-thirds of hypertensive patients take ACE inhibitors/angiotensin receptor blockers,

... host infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the causative agent of COVID-19. As two-thirds of hypertensive patients take ACE inhibitors/angiotensin receptor blockers, several concerns have been raised about the detrimental role of current antihypertensive drugs in COVID-19. ...

Ref: Hypertension prevalence in human coronavirus disease: the role of ACE system in infection spread and severity [Int J Infect Dis, 2020]

multiple regulatory associations have recommended that hypertensive COVID-19 patients do not stop taking their previosuly prescribed ACE inhibitors or ARBs.

... the potential therapeutic effects of these drugs in ARDS caused by SARS-CoV-2 is doubtful. However, multiple regulatory associations have recommended that hypertensive COVID-19 patients do not stop taking their previosuly prescribed ACE inhibitors or ARBs. 20 The evidence offered here precedes any clinical trials, and the paradoxical role of the ...

Ref: Angiotensin-converting-enzyme inhibitors (ACE inhibitors) and angiotensin II receptor blocker (ARB) use in COVID-19 prevention or treatment: A paradox [Infection control and hospital epidemiology, 2020-05-04]

Clinicians should reinforce preventative measures for those patients who must leave their homes to provide blood samples for electrolyte and renal function monitoring with RAAS inhibitors.

... exposure when caring for patients with hypertension, heart failure, acute myocardial infarction, and diabetic nephropathy. Clinicians should reinforce preventative measures for those patients who must leave their homes to provide blood samples for electrolyte and renal function monitoring with RAAS inhibitors. 42 In summary, we have limited preclinical and clinical evidence of the effects of RAAS ...

Ref: Cardiovascular Pharmacology in the Time of COVID-19: A Focus on Angiotensin-Converting Enzyme 2 [J Cardiovasc Pharmacol, 2020-04-13]

Some 15% of cases result in severe disease (so-called COVID-19) characterised by pneumonia and dyspnoea,

... contact. Approximately 80% of SARS-CoV-2 infections are relatively mild (with flu-like symptoms) or even asymptomatic. Some 15% of cases result in severe disease (so-called COVID-19) characterised by pneumonia and dyspnoea, while~5% of SARS-CoV-2-infected individuals experience critical illness (i.e. acute respiratory distress syndrome (ARDS), septic shock, ...

Ref: Renin-angiotensin system inhibition in COVID-19 patients [Neth Heart J, 2020-06-08]

Some Authors recently suggested that angiotensin-converting enzyme (ACE) inhibitors and angiotensin II receptor blockers (ARBs) should be discontinued, even temporarily,

Recent data show the lack of untoward effects of ACE inhibitors or angiotensin receptor blockers for COVID‐19 infection and severity.

... to COVID‐19 but may be also protective versus angiotensin II mediated vasoconstriction and inflammatory activation. Recent data show the lack of untoward effects of ACE inhibitors or angiotensin receptor blockers for COVID‐19 infection and severity. Prospective trials are needed to ascertain whether these drugs may have protective effects. This article ...

Ref: COVID 19 and heart failure: from infection to inflammation and angiotensin II stimulation. Searching for evidence from a new disease [Eur J Heart Fail, 2020-05-15]

Currently available epidemiological studies have reported an increased prevalence of cardiovascular disease (CVD), including hypertension,

... Currently available epidemiological studies have reported an increased prevalence of cardiovascular disease (CVD), including hypertension, among patients who developed a severe subtype of COVID-19 [5] [6] [7] [8] [9] [10] . For example, the study by Guan et al. [5] , which is one of ...

Ref: Cardiovascular Disease and Use of Renin-Angiotensin System Inhibitors in COVID-19 [Am J Cardiovasc Drugs, 2020-04-13]

These results do not support the proposed discontinuation of ACEIs or ARBs for patients with COVID-19.

... evidence for use of ACEIs and ARBs leading to raised ACE2 levels, at least not in serum, that in turn could lead to increased susceptibility to severe outcome in COVID-19. These results do not support the proposed discontinuation of ACEIs or ARBs for patients with COVID-19. ...

Ref: Antihypertensive medication uses and serum ACE2 levels: ACEIs/ARBs treatment does not raise serum levels of ACE2 [medRxiv, 2020-05-25]

Potential but unconfirmed risk factors for coronavirus disease 2019 in adults and children may include hypertension, cardiovascular disease, and chronic kidney disease,

... Potential but unconfirmed risk factors for coronavirus disease 2019 in adults and children may include hypertension, cardiovascular disease, and chronic kidney disease, as well as the medications commonly prescribed for these conditions, angiotensin-converting enzyme inhibitors and angiotensin II receptor blockers. Coronavirus binding to angiotensin-converting enzyme 2, a crucial component of the renin-angiotensin-aldosterone ...

Ref: ACE2, COVID-19, and ACE Inhibitor and ARB Use during the Pandemic: The Pediatric Perspective. [Hypertension, 2020-05-05]

both angiotensin converting enzyme (ACE) inhibitors and angiotensin receptor blockers (ARBs) have been shown to upregulate ACE2 expression in the heart.

... for SARS-CoV-2, the virus that causes COVID-19. In a few experimental studies with animal models, both angiotensin converting enzyme (ACE) inhibitors and angiotensin receptor blockers (ARBs) have been shown to upregulate ACE2 expression in the heart. Though these have not been shown in human studies, or in the setting of COVID-19, ...

Ref: Joint HFSA/ACC/AHA Statement Addresses Concerns Re: Using RAAS Antagonists in COVID-19 [J Card Fail, 2020-05-18]

However, there was no evidence that ACE inhibitors or ARBs affected the risk of COVID-19.

... In this large, population-based study, the use of ACE inhibitors and ARBs was more frequent among patients with Covid-19 than among controls because of their higher prevalence of cardiovascular disease. However, there was no evidence that ACE inhibitors or ARBs affected the risk of COVID-19. ...

Ref: Renin-Angiotensin-Aldosterone System Blockers and the Risk of Covid-19 [N. Engl. j. med, 2020]

Although 301 increased ACE2 expression may elevate the risk of coronavirus infection, it may also 302 have protective effects against ALI.

... coronavirus infection, but is also 300 an important RAAS enzyme that regulates virus infection-induced ALI. Although 301 increased ACE2 expression may elevate the risk of coronavirus infection, it may also 302 have protective effects against ALI. However, the effects of enhanced ACE2 303 expression (such as RAAS inhibition) on SARS-CoV-2 susceptibility ...

Ref: Role and mechanism of angiotensin-converting enzyme 2 in acute lung injury in coronavirus disease 2019 [Chronic Dis Transl Med, 2020-05-19]

Our data support that the renin-angiotensin inhibition does not regulate ACE2 and hence are not likely to increase risk for COVID-19.

... were injected subcutaneously to male C57BL/6J mice for 3 weeks. Abundance of ACE2 mRNA was unchanged in any of the 4 tissues, but TMPRSS2 mRNA was significantly decreased in lungs. Our data support that the renin-angiotensin inhibition does not regulate ACE2 and hence are not likely to increase risk for COVID-19. ...

Ref: Effects of Renin-Angiotensin Inhibition on ACE2 and TMPRSS2 Expression [bioRxiv, 2020-06-12]

Cardiovascular patients show increased risk of severe forms of coronavirus 2019 (COVID- 19) infection (1, 2) .

... Cardiovascular patients show increased risk of severe forms of coronavirus 2019 (COVID- 19) infection (1, 2) . Clinical manifestations are principally respiratory, but some patients may also show cardiovascular complications (1) . The present article reviews the current state of knowledge regarding the relation between the renin-angiotensin-aldosterone ...

Ref: Renin-angiotensin-aldosterone system and COVID-19 infection [Ann Endocrinol (Paris), 2020-04-21]

Mounting evidence from recent clinical studies suggests that RAAS inhibitor use is not related to an increased risk of COVID-19 infection or poor outcomes.

... Mounting evidence from recent clinical studies suggests that RAAS inhibitor use is not related to an increased risk of COVID-19 infection or poor outcomes. In a retrospective cohort study of 18,472 patients screened for COVID-19, test positivity was not significantly associated with ACE inhibitor or ARB therapy [34] . Similarly, in a US study ...

Ref: COVID-19: is there a link between the course of infection and pharmacological agents in diabetes? [J Endocrinol Invest, 2020-06-03]

Patients with cardiovascular disease are at increased risk of critical illness and mortality from Covid-19 disease.

... Background: Patients with cardiovascular disease are at increased risk of critical illness and mortality from Covid-19 disease. Conflicting findings have raised concerns regarding the association of angiotensin converting enzyme inhibitors (ACEI) and angiotensin receptor blockers (ARBs) use with likelihood or severity of infection during this pandemic. ...

Ref: Association of Renin Angiotensin System Blockers with Outcomes in Patients with Covid-19: A Systematic Review and Meta-analysis [J Endocrinol Invest, 2020-05-26]

Only 10 patients (1 case patient and 9 controls) received renin inhibitors,

... cotransporter 2. † Data are for patients who received at least one prescription during 2019. Only 10 patients (1 case patient and 9 controls) received renin inhibitors, and 87 patients (28 case patients and 59 controls) received sacubitril-valsartan. ‡ The Chronic Related ...

Ref: Renin–Angiotensin–Aldosterone System Blockers and the Risk of Covid-19 [N Engl J Med, 2020-05-01]

no study showed the deleterious effect of ACEi/ARB's in Covid-19 patients

... Theoretically, upregulation of ACE2 by ACE i/ARB"s helps the entry of virus inside cell; however, no study showed the deleterious effect of ACEi/ARB"s in Covid-19 patients or causal relationship among ACEi/ARB"s with COVID-19. 10 There is robust evidence of the mortality-lowering ...

Ref: Continue ACE inhibitors/ ARB’S till further evidence in Coronavirus disease 2019 (COVID-19) [Indian Heart J, 2020-05-07]

Preclinical studies have reported that angiotensin receptor blockers (ARBs) and ACE inhibitors might increase ACE2 expression in several cell types.

... principally focusing on the possible effects of commonly used drugs in patients with diabetes. RESULTS: Preclinical studies have reported that angiotensin receptor blockers (ARBs) and ACE inhibitors might increase ACE2 expression in several cell types. Hence, it has been speculated that the treatment with these agents might influence the course ...

Ref: COVID-19: is there a link between the course of infection and pharmacological agents in diabetes? [J. endocrinol. invest, 2020]

use of ACEIs/ARBs in COVID-19 patients should be continued in line with the recent recommendations of medical societies.

... is warranted, there are presently no compelling clinical data showing that ACEIs and ARBs increase the likelihood of contracting COVID-19 or worsen the outcome of SARS-CoV2 infections. Thus, unless contraindicated, use of ACEIs/ARBs in COVID-19 patients should be continued in line with the recent recommendations of medical societies. ...

Ref: Renin-angiotensin system inhibition in COVID-19 patients [Neth. heart j, 2020]

In vitro studies are available to support the eventual role of ACE inhibitors and ARBs in both the promotion and antagonism of the disease.

... mechanisms of Severe Acute Respiratory Syndrome (SARS) during the COVID-19 outbreak due to Cov-2 epidemics. In vitro studies are available to support the eventual role of ACE inhibitors and ARBs in both the promotion and antagonism of the disease. The available literature, indeed, presents contrasting results, all concentrated in experimental models. Evidence in humans ...

Ref: Renin-Angiotensin System Inhibition in Cardiovascular Patients at the Time of COVID19: Much Ado for Nothing? A Statement of Activity from the Directors of the Board and the Scientific Directors of the Italian Society of Hypertension [High Blood Press Cardiovasc Prev, 2020]

Many factors have been associated with both altered ACE2 expression and COVID-19 severity and progression,

... II, the central player in the renin-angiotensin-aldosterone system (RAAS) and the main substrate of ACE2. Many factors have been associated with both altered ACE2 expression and COVID-19 severity and progression, including age, sex, ethnicity, medication and several co-morbidities, such as cardiovascular disease and metabolic syndrome. ...

Ref: Angiotensin-converting enzyme-2 (ACE2), SARS-CoV-2 and pathophysiology of coronavirus disease 2019 (COVID-19) [J. pathol, 2020]

ACE2-expressing organs do not equally participate in COVID-19 pathophysiology,

... widely distributed in various human tissues and many of its determinants have been well recognised, ACE2-expressing organs do not equally participate in COVID-19 pathophysiology, implying that other mechanisms are involved in orchestrating cellular infection resulting in tissue damage. Reports ...

Ref: Angiotensin-converting enzyme-2 (ACE2), SARS-CoV-2 and pathophysiology of coronavirus disease 2019 (COVID-19) [J. pathol, 2020]

The effect of ACE inhibitor (ACEI) treatment during coronaviruses/influenza virus infections in humans is unclear.

... who had SARS-CoV in their hearts. 53 Thus, the use of cardioprotective medications is essential. The effect of ACE inhibitor (ACEI) treatment during coronaviruses/influenza virus infections in humans is unclear. Lei et al. reported that fusion proteins (ACE2-Ig) exhibit potent inhibitory activity against SARS-CoV and ...

Ref: The role of angiotensin-converting enzyme 2 in coronaviruses/influenza viruses and cardiovascular disease [Cardiovasc Res, 2020-04-08]

Recently, investigators have stipulated that COVID-19 patients receiving angiotensin-converting-enzyme inhibitors (ACEI) may be subject to poorer outcomes.

... syndrome coronavirus 2 (SARS-CoV-2) is the virus responsible for the aggressive coronavirus disease (COVID-19) pandemic. Recently, investigators have stipulated that COVID-19 patients receiving angiotensin-converting-enzyme inhibitors (ACEI) may be subject to poorer outcomes. This editorial presents the available evidence to guide treatment practices during this pandemic. RECENT FINDINGS: ...

Ref: Outcomes in Patients with COVID-19 Infection Taking ACEI/ARB [Curr Cardiol Rep, 2020-04-14]

individuals with these comorbidities tended to have greater case fatality rates [3, 4] .

... older age, hypertension, diabetes mellitus, and cardiovascular disease (CVD) was high in COVID-19 patients, and individuals with these comorbidities tended to have greater case fatality rates [3, 4] . In addition, it has been shown that angiotensin-converting enzyme 2 (ACE2) is a functional receptor ...

Ref: Interactions of coronaviruses with ACE2, angiotensin II, and RAS inhibitors—lessons from available evidence and insights into COVID-19 [Hypertens Res, 2020-04-27]

COVID-19 patients have increased Ang II compared to healthy people.

... COVID-19 patients have increased Ang II compared to healthy people. Obesity, air pollution and smoking are associated risk factors which share underlying pathophysiology related to the RAS in SARS-CoV-2 infection. Air pollution via the interference of NO2 increases the ACE ...

Ref: Two important controversial risk factors in SARS-CoV-2 infection: Obesity and smoking [Environ Toxicol Pharmacol, 2020-05-15]

This interaction has been proposed as a potential risk factor in patients treated with RAAS-inhibitors.

... caused by SARS-CoV2 that interfaces with the renin-angiotensin-aldosterone system (RAAS) through angiotensin-converting enzyme 2 (ACE-2). This interaction has been proposed as a potential risk factor in patients treated with RAAS-inhibitors. OBJECTIVES: To analyze if RAAS-inhibitors modify the risk for COVID-19. METHODS: RASTAVI (NCT03201185) is an ...

Ref: Ramipril in High Risk Patients with COVID-19 [J. Am. Coll. Cardiol, 2020]

Kidney transplant recipients are commonly prescribed renin‐angiotensin‐aldosterone system (AAS) inhibitors given the prevalence of hypertension, diabetes, and cardiovascular disease.

... of solid organ transplant recipients who have contracted coronavirus disease 2019 (COVID‐19) are still emerging. Kidney transplant recipients are commonly prescribed renin‐angiotensin‐aldosterone system (AAS) inhibitors given the prevalence of hypertension, diabetes, and cardiovascular disease. As the angiotensin‐converting enzyme 2 (ACE2) facilitates the entry of coronaviruses into target cells, there ...

Ref: What Solid Organ Transplant Healthcare Providers should know about Renin‐Angiotensin‐Aldosterone System Inhibitors and COVID‐19 [Clin Transplant, 2020-05-23]

Covid-19 patients with cardiovascular disease are at increased risk of death.

... SARS-CoV-2 pandemic has high fatality rates and imposes increasingly severe social and economic impacts worldwide. Covid-19 patients with cardiovascular disease are at increased risk of death. They are very often treated with drugs targeting the renin-angiotensin-aldosterone system, where angiotensin converting enzyme ...

Ref: An epidemiological study exploring a possible impact of treatment with ACE inhibitors or angiotensin receptor blockers on ACE2 plasma concentrations [J Mol Cell Cardiol, 2020-04-05]

Further clinical insights from Wuhan suggest that some patients with COVID-19 exhibit severe cardiovascular damage,

... clinical course predominantly involving respiratory manifestations, the clinical course of the novel coronavirus is unclear. Further clinical insights from Wuhan suggest that some patients with COVID-19 exhibit severe cardiovascular damage, and those with underlying cardiovascular disease appear to have an increased risk of death [1, ...

Ref: Clinical Implications of SARS-Cov2 Interaction with Renin Angiotensin System [J Am Coll Cardiol, 2020-04-16]

Pre-existent cardiovascular disease is a recognized risk factor for COVID-19 infection (1) .

... Pre-existent cardiovascular disease is a recognized risk factor for COVID-19 infection (1) . COVID-19 spike protein uses the angiotensin-converting-enzyme 2 (ACE2) as the binding site to enter the host cell in tongue, bronchi and lungs. Any condition enhancing the expression of ACE2 would ...

Ref: Angiotensin-Converting Enzyme 2 as the Molecular Bridge Between Epidemiologic and Clinical Features of COVID-19 [Can J Cardiol, 2020-03-29]

studies thus far have not concluded a benefit or risk associated with the use of either ACE-inhibitors or angiotensin receptor antagonists.

... for edema are not effective. Angiotensin-converting enzyme 2 (ACE2) is a co-receptor for SARS-CoV-2, and studies thus far have not concluded a benefit or risk associated with the use of either ACE-inhibitors or angiotensin receptor antagonists. Summary Activation of complement and the contact system, through generation of bradykinin, may play a ...

Ref: cord_uid pbuevs5v A Review: Does Complement or the Contact Syste... pbuevs5v A Review: Does Complement or the Contact Syste... Name: title, dtype: object [Can J Cardiol, cord_uid pbuevs5v 2020-05-13 pbuevs5v 2020-05-13 Name: publish_time, dtype: object]

In the current COVID-19 pandemic, our findings do not support a change in ACE inhibitor medication use without clinical justification.

... other cardiometabolic traits with the outcomes. Conclusions: This study does not provide evidence to support that ACE inhibitor antihypertensive drugs affect lung ACE2 and TMPRSS2 expression or plasma ACE2 levels. In the current COVID-19 pandemic, our findings do not support a change in ACE inhibitor medication use without clinical justification. ...

Ref: ACE inhibition and cardiometabolic risk factors, lung ACE2 and TMPRSS2 gene expression, and plasma ACE2 levels: a Mendelian randomization study [Can J Cardiol, 2020-04-14]

is not associated with an increased risk of infection with severe acute respiratory syndrome coronavirus 2

... According to five new studies, therapy with angiotensin-converting enzyme (ACE) inhibitors or angiotensin-receptor blockers (ARBs) is not associated with an increased risk of infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) or with an increased risk of severe disease or in-hospital death among patients with ...

Ref: RAAS inhibitors do not increase the risk of COVID-19 [Nat Rev Cardiol, 2020-05-22]

we found no increased risk with either ACE inhibitors or angiotensin-receptor blockers.

... antihypertensive drugs, once fully adjusted for age, sex, and cardiovascular comorbidities and risk factors. Additionally, we found no increased risk with either ACE inhibitors or angiotensin-receptor blockers. The lack of association between RAAS inhibitors and risk of COVID-19 requiring admission to hospital ...

Ref: Use of renin–angiotensin–aldosterone system inhibitors and risk of COVID-19 requiring admission to hospital: a case-population study [Lancet, 2020-05-14]

should not be withheld.

... benefits of lung function improvement in SARS-CoV infections, we hypothesize that the benefits of treatment with renin-angiotensin system inhibitors in SARS-COV2 may outweigh the risks and at the very least should not be withheld. ...

Ref: Clinical Implications of SARS-Cov2 Interaction with Renin Angiotensin System [J. Am. Coll. Cardiol, 2020]

No increased risk of in-hospital death was found to be associated with the use of ACE inhibitors

... No increased risk of in-hospital death was found to be associated with the use of ACE inhibitors (2.1% vs. 6.1%; odds ratio, 0.33; 95% CI, 0.20 to 0.54) or the use of ARBs (6.8% vs. 5.7%; odds ratio, 1.23; 95% CI, 0.87 to 1.74). ...

Ref: Is Hypertension a Real Risk Factor for Poor Prognosis in the COVID-19 Pandemic? [Curr Hypertens Rep, 2020-06-13]

Many patients and their physicians, including those in South Africa, have contemplated a cessation of ACE inhibitors or ARB medications.

... RAAS antagonists such as ACE inhibitors and ARBs confer an increased risk of COVID-19 infection. Many patients and their physicians, including those in South Africa, have contemplated a cessation of ACE inhibitors or ARB medications. In the Wuhan study, (2) there was no information of how many of the patients ...

Ref: Should ACE Inhibitors and Angiotensin Receptor Blockers Be Withdrawn in the Current Setting of COVID-19 Infection? [Curr Hypertens Rep, 2020-04-19]

previous observations on SARS-CoV might be relevant to the COVID-19 disease, which is often complicated by acute lung failure.

... has been suggested that ARBs might be beneficial in acute lung injury. In this regard, previous observations on SARS-CoV might be relevant to the COVID-19 disease, which is often complicated by acute lung failure. Indeed, it has been demonstrated that the coronavirus spike protein binds to ACE2, leading to ...

Ref: Might renin–angiotensin system blockers play a role in the COVID-19 pandemic? [Eur Heart J Cardiovasc Pharmacother, 2020-04-14]

these patients would represent a substantial group of people at risk.

... inhibitor (lisinopril) and an ARB (losartan) are both among the 10 most commonly used drugs with a combined 152 million prescriptions per year in the USA alone (IQVIA Institute 2019), these patients would represent a substantial group of people at risk. ...

Ref: COVID-19 pandemic and therapy with ibuprofen or renin-angiotensin system blockers: no need for interruptions or changes in ongoing chronic treatments [Naunyn Schmiedebergs Arch Pharmacol, 2020-05-15]

Angiotensin-converting enzyme inhibitors (ACEi) principally inhibit ACE1, thus blocking angiotensin II release.

... Angiotensin-converting enzyme inhibitors (ACEi) principally inhibit ACE1, thus blocking angiotensin II release. (Figure 1 ); ACE2 is insensitive to ACEIs [32, 33] . ACEi, like ARB, are widely prescribed as maintenance therapy in several chronic cardiovascular diseases, including arterial hypertension, heart failure ...

Ref: Renin-angiotensin-aldosterone system and COVID-19 infection [Therapie, 2020-05-20]

The implications of such RAS imbalance for pulmonary manifestations in severe acute distress syndromes were not unnoticed [9] .

... of Covid-19, added by viral activation of the innate and adaptive immune response [8] . The implications of such RAS imbalance for pulmonary manifestations in severe acute distress syndromes were not unnoticed [9] . In this context, experimental mice models of SARS-CoV mediated lung injury had previously shown diminished ...

Ref: Covid-19: the renin–angiotensin system imbalance hypothesis [Clin Sci (Lond), 2020-06-08]

no study has been done investigating this hypothesis and current data do not justify the discontinuation of ACE inhibitors in patients at risk or with COVID-19.

... of its effects of vasodilation, increase in vascular permeability, and cough reflex exacerbation. 7 However, no study has been done investigating this hypothesis and current data do not justify the discontinuation of ACE inhibitors in patients at risk or with COVID-19. FIGURE 1 . Interaction between the renin-angiotensin-aldosterone system and the bradykinin system. During SARS-CoV-2 infection, ...

Ref: Debate on Drugs That May Aggravate COVID-19 [J Allergy Clin Immunol Pract, 2020-04-25]

We were not able to confirm previous concerns regarding a potential harmful association of ACE inhibitors or ARBs with in-hospital mortality in this clinical context.

... with In this multinational observational study involving patients hospitalized with Covid-19, we confirmed previous observations suggesting that underlying cardiovascular disease is independently associated with an increased risk of in-hospital death. We were not able to confirm previous concerns regarding a potential harmful association of ACE inhibitors or ARBs with in-hospital mortality in this clinical context. ...

Ref: Cardiovascular Disease, Drug Therapy, and Mortality in Covid-19 [N Engl J Med, 2020-05-01]

hypertensive COVID-19 patients do not stop taking their previosuly prescribed ACE inhibitors or ARBs.

... drugs in ARDS caused by SARS-CoV-2 is doubtful. However, multiple regulatory associations have recommended that hypertensive COVID-19 patients do not stop taking their previosuly prescribed ACE inhibitors or ARBs. 20 The evidence offered here precedes any clinical trials, and the paradoxical role of the ...

During those outbreaks it was observed a particularly elevated incidence of cardiovascular disease among patients,

... Coronavirus-related SARS known as the Middle East Respiratory Distress Syndrome (MERS) of 2002 and 2013. During those outbreaks it was observed a particularly elevated incidence of cardiovascular disease among patients, who were also characterized by being elderly and, in particular during the MERS, prevalently male ...

ACE (angiotensin-converting enzyme) inhibitors, and Ang II (angiotensin II) receptor blockers.

... disease, and chronic kidney disease, as well as the medications commonly prescribed for these conditions, ACE (angiotensin-converting enzyme) inhibitors, and Ang II (angiotensin II) receptor blockers. Coronavirus binding to ACE2 (angiotensin-converting enzyme 2), a crucial component of the renin-angiotensin-aldosterone system, underlies ...

Ref: ACE2 (Angiotensin-Converting Enzyme 2), COVID-19, and ACE Inhibitor and Ang II (Angiotensin II) Receptor Blocker Use During the Pandemic: The Pediatric Perspective [Hypertension, 2020]

Additionally, we found no increased risk with either ACE inhibitors or angiotensin-receptor blockers.

... other antihypertensive drugs, once fully adjusted for age, sex, and cardiovascular comorbidities and risk factors. Additionally, we found no increased risk with either ACE inhibitors or angiotensin-receptor blockers. The lack of association between RAAS inhibitors and risk of COVID-19 requiring admission to hospital ...

Ref: Use of renin–angiotensin–aldosterone system inhibitors and risk of COVID-19 requiring admission to hospital: a case-population study [Lancet, 2020-05-14]

Clinicians should consider the risk of COVID-19 exposure when caring for patients with hypertension, heart failure, acute myocardial infarction, and diabetic nephropathy.

... European Society of Cardiology issued recommendations against discontinuing RAAS inhibitors during the COVID-19 pandemic. 40,41 Clinicians should consider the risk of COVID-19 exposure when caring for patients with hypertension, heart failure, acute myocardial infarction, and diabetic nephropathy. Clinicians should reinforce preventative measures for those patients who must leave their homes to provide ...

Ref: Cardiovascular Pharmacology in the Time of COVID-19: A Focus on Angiotensin-Converting Enzyme 2 [J Cardiovasc Pharmacol, 2020-04-13]

Recent reports suggest an association with use of renin-angiotensin-aldosterone system (RAAS) inhibitors.

... a wide age group but predominantly elderly individuals, especially men and those with cardiovascular disease. Recent reports suggest an association with use of renin-angiotensin-aldosterone system (RAAS) inhibitors. Angiotensin-converting enzyme 2 (ACE2) is a functional receptor for coronaviruses. Higher ACE2 concentrations might lead ...

Ref: Circulating plasma concentrations of angiotensin-converting enzyme 2 in men and women with heart failure and effects of renin-angiotensin-aldosterone inhibitors [Eur Heart J, 2020]

the safety and potential effects of antihypertension therapy with ACE inhibitors or angiotensin-receptor blockers in patients with COVID-19 should be carefully considered'.

suggest that "the safety and potential effects of antihypertension therapy with ACE inhibitors or angiotensin-receptor blockers in patients with COVID-19 should be carefully considered".

Ref: Interaction between RAAS inhibitors and ACE2 in the context of COVID-19 [Nat Rev Cardiol, 2020-03-30]

There are no controlled studies on the use of ACE inhibitors and ARBs in patients with COVID-19.

... (1) There are no controlled studies on the use of ACE inhibitors and ARBs in patients with COVID-19. (2) The clinical evidence is inconclusive. While one study in China did not find any association of ACE inhibitor use with severity of disease, there was an increased mortality ...

Ref: cord_uid 4ti8l2ea Diabetes and COVID-19: evidence, current statu... 4ti8l2ea Diabetes and COVID-19: evidence, current statu... Name: title, dtype: object [Nat Rev Cardiol, cord_uid 4ti8l2ea 2020-05-13 4ti8l2ea 2020-05-13 Name: publish_time, dtype: object]

many of those patients are treated with RAS blockers (12) (13) (14) .

... hypertension, heart disease, diabetes mellitus, and clearly the elderly are at risk of COVID-19 and many of those patients are treated with RAS blockers (12) (13) (14) . Concerns came from previous studies showing that angiotensin II type 1 receptor blockers and ACE ...

Ref: Kidney and Lung ACE2 expression after an ACE inhibitor or an Ang II receptor blocker: implications for COVID-19 [bioRxiv, 2020-05-20]

those with underlying cardiovascular disease appear to have an increased risk of death [1, 2] .

... course predominantly involving respiratory manifestations, the clinical course of the novel coronavirus is unclear. Further clinical insights from Wuhan suggest that some patients with COVID-19 exhibit severe cardiovascular damage, and those with underlying cardiovascular disease appear to have an increased risk of death [1, 2] . ...

Ref: Clinical Implications of SARS-Cov2 Interaction with Renin Angiotensin System [J Am Coll Cardiol, 2020-04-16]

Should patients with hypertension stop using RASI?

... RASI can increase the expression of ACE2, leading to the higher risk of SARS-CoV-2 infection. Should patients with hypertension stop using RASI? We explored the question about the effects of administering RASI to patients with COVID-19 and ...

Ref: The effects of renin-angiotensin system inhibitors (RASI) in Corona Virus Disease (COVID-19) with Hypertension: A retrospective, single-center trial [Med Clin (Barc), 2020-06-11]

there was no evidence that ACE inhibitors or ARBs affected the risk of COVID-19.

... this large, population-based study, the use of ACE inhibitors and ARBs was more frequent among patients with Covid-19 than among controls because of their higher prevalence of cardiovascular disease. However, there was no evidence that ACE inhibitors or ARBs affected the risk of COVID-19. ...

Ref: Renin-Angiotensin-Aldosterone System Blockers and the Risk of Covid-19 [N. Engl. j. med, 2020]

Taking ACEI or ARB drugs may not change the prognosis of COVID-19 patients with hypertension.

... history of hypertension had a significantly lower lymphocyte count on admission. The elderly and comorbidities such as hypertension may together constitute risk factors for poor prognosis in patients with COVID-19. Taking ACEI or ARB drugs may not change the prognosis of COVID-19 patients with hypertension. ...

Ref: Clinical characteristics of coronavirus disease 2019 (COVID-19) patients with hypertension on renin–angiotensin system inhibitors [Clin Exp Hypertens, 2020-05-13]

ACE inhibitors or angiotensin II (Ang)-type 1 receptor blockers (ARBs), in fact, have been suggested to be avoided

... has resulted in conflicting suggestions regarding how RAS and its role(s) should inform treating COVID-19. ACE inhibitors or angiotensin II (Ang)-type 1 receptor blockers (ARBs), in fact, have been suggested to be avoided as they potentially upregulate ACE2 1 and, conversely, there are suggestions that ARBs might be ...

Ref: ACE2 and prognosis of COVID-19. Insights from Bartter's and Gitelman's syndromes patients [J. med. virol, 2020]

COVID-19 may be associated with high rates of myocarditis and heart failure in the critically ill.

... an effect, though local tissue ACE2 levels were not measured. [54] . Through anecdotal reports, COVID-19 may be associated with high rates of myocarditis and heart failure in the critically ill. While beyond the scope of this proposal, we will note that increased Ang II and ...

Ref: Understanding the Renin-Angiotensin-Aldosterone-SARS-CoV-Axis: A Comprehensive Review [Eur Respir J, 2020-04-27]

the lack of analyses for the use of ACE2 inhibitors among hypertensive patients detracts from the value of the developed score.

... On the premises of the article determining a host risk score, the lack of analyses for the use of ACE2 inhibitors among hypertensive patients detracts from the value of the developed score. Given that the effect of both ACE inhibitors/ARBs on disease course is largely unknown and the focus of further ...

Ref: Letter to the editor: The role of angiotensin-converting enzyme inhibitors and angiotensin receptor blockers in developing a COVID-19 comorbidity-based host risk score [Crit Care, 2020-05-19]

ACEIs could potentially decrease the severity and mortality of COVID-19.

... https://doi.org/10.1101/2020.05. 21.20108993 doi: medRxiv preprint In conclusion, the risk of severe COVID-19 or death was less likely in patients receiving RAAS inhibitors compared to those taking non-RAAS inhibitor antihypertensive agents. ACEIs could potentially decrease the severity and mortality of COVID-19. ...

Ref: Comparison of renin-angiotensin-aldosterone system inhibitors with other antihypertensives in association with coronavirus disease-19 clinical outcomes: systematic review and meta-analysis [Crit Care, 2020-05-25]

is not associated with an increased risk of infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)

Ref: RAAS inhibitors do not increase the risk of COVID-19 [Nat Rev Cardiol, 2020-05-22]

Clinical observations showed that plasma Ang II levels increased significantly in COVID-19 patients [5] ,

... of virus invasion, but also mediates lung injury and lung failure caused by virus infection. Clinical observations showed that plasma Ang II levels increased significantly in COVID-19 patients [5] , which further suggests that COVID-19 binding to ACE2 leads to excessive release of Ang II ...

Ref: A close-up on COVID-19 and cardiovascular diseases [Nutr Metab Cardiovasc Dis, 2020-04-08]

First, there is no epidemiologic evidence for increased severe COVID-19 or mortality in patients who were taking RAS inhibitors.

... would like to emphasize that currently, there is no scientific basis for taking such measures. First, there is no epidemiologic evidence for increased severe COVID-19 or mortality in patients who were taking RAS inhibitors. Second, it is still unclear whether or not RAS inhibition results in increased expression of ...

Ref: Is the use of RAS inhibitors safe in the current era of COVID-19 pandemic? [Clin Hypertens, 2020-05-07]

The findings of current trials using ARBs as well as early phase 2B trials using intravenous recombinant human ACE2

... in SARS-CoV-2. It is thus suggested that modulators of the RAAS system may be therapeutic targets against SARS-CoV-2. The findings of current trials using ARBs as well as early phase 2B trials using intravenous recombinant human ACE2 may provide further evidence to support the suggestions of Bombardini et.al. (4) ...

Ref: What is the Role of Angiotensin Converting Enzyme 2 (ACE2) in COVID-19 Infection in Hypertensive, Diabetic Patients? [Can J Cardiol, 2020-04-08]

There has been speculation that patients with COVID-19 who are receiving these agents may be at increased risk for adverse outcomes,

... and angiotensin II type I receptor blockers (ARBs), among patients with COVID-19 [11, 12] . There has been speculation that patients with COVID-19 who are receiving these agents may be at increased risk for adverse outcomes, given that ACE2 is a functional receptor for SARS-CoV-2 and RAS inhibitors can increase ACE2 ...

Ref: Cardiovascular Disease and Use of Renin-Angiotensin System Inhibitors in COVID-19 [Am J Cardiovasc Drugs, 2020-04-13]

Patients with hypertension and diabetes have been seen to experience a high case-fatality rate.

... ARB increase susceptibility to infection by SARS-CoV-2 and worsen the prognosis of patients with Covid-19? Patients with hypertension and diabetes have been seen to experience a high case-fatality rate. This observation has led to concerns about the safety and the potential effects of therapies ...

Ref: Covid-19 and cardiovascular risk: susceptibility to infection to SARS-CoV-2, severity and prognosis of Covid-19 and blockade of the renin-angiotensin-aldosterone system. An evidence-based viewpoint [Nutr Metab Cardiovasc Dis, 2020-05-29]

188 patient taking ACEI/ARB had a lower all-cause mortality than non-ACEI/ARB group

... However, in a retrospective, multi-center study of 1128 adult patients with hypertension diagnosed with COVID-19, 188 patient taking ACEI/ARB had a lower all-cause mortality than non-ACEI/ARB group (adjusted HR = 0.42; 95% CI: 0.19-0.92; P = 0.03). 98 This study suggests, although ...

Ref: Coronavirus Disease 2019 and Stroke: Clinical Manifestations and Pathophysiological Insights [J Stroke Cerebrovasc Dis, 2020-05-12]

Covid-19 is particularly severe in patients with underlying cardiovascular diseases,

... for harm related to the withdrawal of RAAS inhibitors in patients in otherwise stable condition. Covid-19 is particularly severe in patients with underlying cardiovascular diseases, 9 and in many of these patients, active myocardial injury, 14,54,58-60 myocardial stress, 59 and ...

Ref: Renin–Angiotensin–Aldosterone System Inhibitors in Patients with Covid-19 [N Engl J Med, 2020-03-30]

However, multiple regulatory associations have recommended that hypertensive COVID-19 patients do not stop taking their previosuly prescribed ACE inhibitors or ARBs.

... widespread; the potential therapeutic effects of these drugs in ARDS caused by SARS-CoV-2 is doubtful. However, multiple regulatory associations have recommended that hypertensive COVID-19 patients do not stop taking their previosuly prescribed ACE inhibitors or ARBs. 20 The evidence offered here precedes any clinical trials, and the paradoxical role of the ...

It has been suggested that use of ACE inhibitors may exacerbate symptoms in COVID-19 patients and have led to controversies.

... renal function. Hence it could be used in patients with cystinuria and other comorbidities. 1 It has been suggested that use of ACE inhibitors may exacerbate symptoms in COVID-19 patients and have led to controversies. 2 The angiotensin-converting enzyme 2 (ACE2), an enzyme that physiologically counters the renin-angitensin-aldesterone system activation ...

Ref: The use of Captopril - angiotensin converting enzyme (ACE) inhibitor for cystinuria during COVID-19 pandemic [Urology, 2020-04-22]

ACE inhibitors or angiotensin II (Ang)‐type 1 receptor blockers (ARBs), in fact, have been suggested to be avoided

... has resulted in conflicting suggestions regarding how RAS and its role(s) should inform treating COVID‐19. ACE inhibitors or angiotensin II (Ang)‐type 1 receptor blockers (ARBs), in fact, have been suggested to be avoided as they potentially upregulate ACE2 (1) and, conversely, there are suggestions that ARBs might be ...

Ref: ACE2 and prognosis of COVID‐19. Insights from Bartter's and Gitelman's syndromes patients [J Med Virol, 2020-05-06]

use of ACE inhibitors was associated with a better survival among patients with Covid-19.

... outcomes [8] [9] [10] . Interestingly, in Mehra et al. study but not in others, use of ACE inhibitors was associated with a better survival among patients with Covid-19. However, these results must be considered with caution due to the unmeasured confounding of this ...

Ref: Authors’ reply to correspondence in response to “Will children reveal their secret? The coronavirus dilemma” [Eur Respir J, 2020-05-19]