COVID-19 and Angiotensin-Converting Enzyme Inhibitors and Angiotensin Receptor Blockers: What Is the Evidence?

• Published in: JAMA : the journal of the American Medical Association Vol. 323; no. 18; pp. 1769 - 1770
• Main Authors: Patel, Ankit B, Verma, Ashish
• Format: Journal Article
• Language: English
• Published: United States American Medical Association 12.05.2020
• Subjects: Angiotensin; Angiotensin Receptor Antagonists - adverse effects; Angiotensin Receptor Antagonists - therapeutic use; Angiotensin-Converting Enzyme 2; Angiotensin-converting enzyme inhibitors; Angiotensin-Converting Enzyme Inhibitors - adverse effects; Angiotensin-Converting Enzyme Inhibitors - therapeutic use; Animals; Antihypertensive Agents - adverse effects; Antihypertensive Agents - therapeutic use; Betacoronavirus; Coronavirus Infections - complications; Coronavirus Infections - epidemiology; Coronaviruses; COVID-19; Diuretics; Enzyme inhibitors; Enzymes; Humans; Hypertension - complications; Hypertension - drug therapy; Lung Injury - drug therapy; Lung Injury - enzymology; Mice; Pandemics; Peptidyl-dipeptidase A; Peptidyl-Dipeptidase A - drug effects; Peptidyl-Dipeptidase A - metabolism; Pneumonia, Viral - complications; Pneumonia, Viral - epidemiology; Receptors; SARS Virus - pathogenicity; SARS-CoV-2; Vasodilation - physiology; Virus Internalization
• ISSN: 0098-7484; 1538-3598; 1538-3598
• DOI: 10.1001/jama.2020.4812

This Viewpoint reviews the pathophysiological and observational basis for speculating that angiotensin-converting enzyme inhibitors (ACEIs) and angiotensin receptor blockers (ARBs) might worsen clinical outcomes for patients with COVID-19, and summarizes guidance from specialty societies to continue the drugs in patients who need them pending more definitive evidence of harm.