Angiotensin-converting enzyme (ACE) inhibitors (ACEIs) and angiotensin II type‑1 receptor blockers (ARBs) are among the most widely prescribed drugs for the treatment of arterial hypertension, heart failure and chronic kidney disease. A number of studies, mainly in animals and not involving the lungs, have indicated that these drugs can increase expression of angiotensin-converting enzyme 2 (ACE2). ACE2 is the cell entry receptor of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the causative agent of coronavirus disease 2019 (COVID-19) that is currently battering the globe. This has led to the hypothesis that use of ACEIs and ARBs may increase the risk of developing severe COVID-19. In this point of view paper, possible scenarios regarding the impact of ACEI/ARB pharmacotherapy on COVID-19 are discussed in relation to the currently available evidence. Although further research on the influence of blood-pressure-lowering drugs, including those not targeting the renin-angiotensin system, 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-CoV‑2 infections. Thus, unless contraindicated, use of ACEIs/ARBs in COVID-19 patients should be continued in line with the recent recommendations of medical societies.
【저자키워드】 Coronavirus disease 2019, renin-angiotensin system, Angiotensin-converting enzyme, angiotensin-converting enzyme inhibitor, Severe acute respiratory syndrome coronavirus 2, Angiotensin II type‑1 receptor blocker, 【초록키워드】 COVID-19, Treatment, coronavirus disease, SARS-CoV-2, ACE2, severe COVID-19, drugs, risk, Chronic kidney disease, drug, outcome, angiotensin-converting enzyme 2, ARB, heart failure, infections, Lungs, Research, receptor, inhibitor, expression, SARS-CoV‑2, ACEi, Evidence, Hypothesis, ACE, ACEIs, ARBs, COVID-19 patient, Arterial hypertension, acute respiratory syndrome, Clinical data, enzyme, blocker, recommendation, likelihood, cell entry receptor, globe, indicated, 【제목키워드】 COVID-19 patient,