Relationship between angiotensin-converting enzyme inhibitors, angiotensin II receptor blockers and SARS-CoV-2 infection: where are we?

Minerva Cardioangiol. 2020 Aug;68(4):339-346. doi: 10.23736/S0026-4725.20.05271-8. Epub 2020 May 29.

Abstract

In recent months SARS-CoV-2 has spread rapidly throughout the world. The case fatality rate is higher in cardiovascular disease and hypertension. Other comorbidities do not seem to confer the same risk, therefore the understanding of the relationship between infection and cardiovascular system could be a crucial point for the fight against the virus. A great interest is directed towards the angiotensin 2 converting enzyme (ACE 2) which is the SARS-CoV-2 receptor and creates important connections between the virus replication pathway, the cardiovascular system and blood pressure. All cardiovascular conditions share an imbalance of the renin angiotensin system in which ACE 2 plays a central role. In the early pandemic period, much confusion has appeared about the management of therapy with angiotensin converting enzyme inhibitors and angiotensin receptor blockers especially in infected patients and in those at risk of critical illness in case of infection. In this article we will try to reorder the major opinions currently emerging on this topic.

Publication types

  • Review

MeSH terms

  • Angiotensin II Type 1 Receptor Blockers / therapeutic use*
  • Angiotensin Receptor Antagonists / therapeutic use*
  • Angiotensin-Converting Enzyme Inhibitors / therapeutic use*
  • Animals
  • Antihypertensive Agents / therapeutic use
  • COVID-19
  • Coronavirus Infections / drug therapy*
  • Coronavirus Infections / physiopathology
  • Humans
  • Pandemics
  • Pneumonia, Viral / drug therapy*
  • Pneumonia, Viral / physiopathology
  • Renin-Angiotensin System

Substances

  • Angiotensin II Type 1 Receptor Blockers
  • Angiotensin Receptor Antagonists
  • Angiotensin-Converting Enzyme Inhibitors
  • Antihypertensive Agents