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J Intern Med COVID-19 and Renin-Angiotensin System Inhibition - Role of Angiotensin Converting Enzyme 2 (ACE2) - Is There Any Scientific Evidence for Controversy?

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  • J Intern Med COVID-19 and Renin-Angiotensin System Inhibition - Role of Angiotensin Converting Enzyme 2 (ACE2) - Is There Any Scientific Evidence for Controversy?


    J Intern Med


    . 2020 May 27.
    doi: 10.1111/joim.13101. Online ahead of print.
    COVID-19 and Renin-Angiotensin System Inhibition - Role of Angiotensin Converting Enzyme 2 (ACE2) - Is There Any Scientific Evidence for Controversy?


    Aneta Aleksova 1 , Federico Ferro 1 , Giulia Gagno 1 , Chiara Cappelletto 1 , Daniela Santon 1 , Maddalena Rossi 1 , Giuseppe Ippolito 2 , Alimuddin Zumla 3 4 , Antonio P Beltrami 5 , Gianfranco Sinagra 1



    Affiliations

    Abstract

    Renin-angiotensin system (RAS) blockers are extensively used worldwide to treat many cardiovascular disorders, where they are effective in reducing both mortality and morbidity. These drugs are known to induce an increased expression of Angiotensin Converting Enzyme 2 (ACE2). ACE2 acts as receptor for the novel SARS-Coronavirus-2 (SARS-CoV-2) which raising the important issue of possible detrimental effects that RAS blockers could exert on the natural history and pathogenesis of the COronaVIrus Disease 19 (COVID-19) and associated excessive inflammation, myocarditis, and cardiac arrhythmias. We review the current knowledge on the interaction between SARS-CoV-2 infection and RAS blockers and suggest a scientific rationale for continuing RAS blockers therapy in patients with COVID-19 infection.

    Keywords: ACEIs/ARBs; Angiotensin Converting Enzyme 2 (ACE2); COVID-19; Cardiovascular system; RAAS; SARS-Coronavirus (CoV)-2; pandemic.

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