Debatable points of using angiotensin-converting enzyme inhibitors and angiotensin receptor antagonists in patients with COVID-19

The COVID-19 pandemic is a serious threat to global health. The infection mechanism is the binding of SARS-CoV-2 to angiotensin-converting enzyme 2 (ACE2) and internalization of the complex by the host cell. ACE inhibitors/angiotensin receptor antagonists (ARA) are known to increase ACE2 expression...

Full description

Saved in:
Bibliographic Details
Main Authors: O. M. Drapkina, L. E. Vasilyeva
Format: Article
Language:Russian
Published: «SILICEA-POLIGRAF» LLC 2020-07-01
Series:Кардиоваскулярная терапия и профилактика
Subjects:
Online Access:https://cardiovascular.elpub.ru/jour/article/view/2580
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1849698996491124736
author O. M. Drapkina
L. E. Vasilyeva
author_facet O. M. Drapkina
L. E. Vasilyeva
author_sort O. M. Drapkina
collection DOAJ
description The COVID-19 pandemic is a serious threat to global health. The infection mechanism is the binding of SARS-CoV-2 to angiotensin-converting enzyme 2 (ACE2) and internalization of the complex by the host cell. ACE inhibitors/angiotensin receptor antagonists (ARA) are known to increase ACE2 expression and are recommended for the treatment of many cardiovascular diseases (CVD). Thus, it has been suggested that treatment with renin-angiotensin-aldosterone system blockers (RAAS) increases the viral load and the risk of severe acute respiratory distress syndrome. However, ACE2 also converts angiotensin II into substances with cardioprotective effects. In addition, there is no evidence that RAAS inhibitors increase the severity of COVID-19 infection, while the risks of withdrawal of ACE inhibitors/ARA in patients with CVD are proven. There is also no evidence to support the idea that the administration of ACE inhibitors/ARA promotes the coronavirus’s penetration by increasing the ACE2 expression. According to the guidelines of the Russian Society of Cardiology and the consensus statements of international cardiology societies, it is necessary to continue taking RAAS inhibitors in high-risk patients with COVID-19. This review provides an analysis of foreign articles revealing the pathophysiological pathways and recommendations for using ACE inhibitors/ARA in patients with CVD and COVID-19 infection.
format Article
id doaj-art-458f6e6ed24d45bea6bdecb9556edae5
institution DOAJ
issn 1728-8800
2619-0125
language Russian
publishDate 2020-07-01
publisher «SILICEA-POLIGRAF» LLC
record_format Article
series Кардиоваскулярная терапия и профилактика
spelling doaj-art-458f6e6ed24d45bea6bdecb9556edae52025-08-20T03:18:45Zrus«SILICEA-POLIGRAF» LLCКардиоваскулярная терапия и профилактика1728-88002619-01252020-07-0119310.15829/1728-8800-2020-25802112Debatable points of using angiotensin-converting enzyme inhibitors and angiotensin receptor antagonists in patients with COVID-19O. M. Drapkina0L. E. Vasilyeva1National Medical Research Center for Therapy and Preventive MedicineNational Medical Research Center for Therapy and Preventive MedicineThe COVID-19 pandemic is a serious threat to global health. The infection mechanism is the binding of SARS-CoV-2 to angiotensin-converting enzyme 2 (ACE2) and internalization of the complex by the host cell. ACE inhibitors/angiotensin receptor antagonists (ARA) are known to increase ACE2 expression and are recommended for the treatment of many cardiovascular diseases (CVD). Thus, it has been suggested that treatment with renin-angiotensin-aldosterone system blockers (RAAS) increases the viral load and the risk of severe acute respiratory distress syndrome. However, ACE2 also converts angiotensin II into substances with cardioprotective effects. In addition, there is no evidence that RAAS inhibitors increase the severity of COVID-19 infection, while the risks of withdrawal of ACE inhibitors/ARA in patients with CVD are proven. There is also no evidence to support the idea that the administration of ACE inhibitors/ARA promotes the coronavirus’s penetration by increasing the ACE2 expression. According to the guidelines of the Russian Society of Cardiology and the consensus statements of international cardiology societies, it is necessary to continue taking RAAS inhibitors in high-risk patients with COVID-19. This review provides an analysis of foreign articles revealing the pathophysiological pathways and recommendations for using ACE inhibitors/ARA in patients with CVD and COVID-19 infection.https://cardiovascular.elpub.ru/jour/article/view/2580covid-19sars-cov-2angiotensin converting enzyme inhibitorsangiotensin receptor antagonistsangiotensin converting enzyme 2cardiovascular diseases
spellingShingle O. M. Drapkina
L. E. Vasilyeva
Debatable points of using angiotensin-converting enzyme inhibitors and angiotensin receptor antagonists in patients with COVID-19
Кардиоваскулярная терапия и профилактика
covid-19
sars-cov-2
angiotensin converting enzyme inhibitors
angiotensin receptor antagonists
angiotensin converting enzyme 2
cardiovascular diseases
title Debatable points of using angiotensin-converting enzyme inhibitors and angiotensin receptor antagonists in patients with COVID-19
title_full Debatable points of using angiotensin-converting enzyme inhibitors and angiotensin receptor antagonists in patients with COVID-19
title_fullStr Debatable points of using angiotensin-converting enzyme inhibitors and angiotensin receptor antagonists in patients with COVID-19
title_full_unstemmed Debatable points of using angiotensin-converting enzyme inhibitors and angiotensin receptor antagonists in patients with COVID-19
title_short Debatable points of using angiotensin-converting enzyme inhibitors and angiotensin receptor antagonists in patients with COVID-19
title_sort debatable points of using angiotensin converting enzyme inhibitors and angiotensin receptor antagonists in patients with covid 19
topic covid-19
sars-cov-2
angiotensin converting enzyme inhibitors
angiotensin receptor antagonists
angiotensin converting enzyme 2
cardiovascular diseases
url https://cardiovascular.elpub.ru/jour/article/view/2580
work_keys_str_mv AT omdrapkina debatablepointsofusingangiotensinconvertingenzymeinhibitorsandangiotensinreceptorantagonistsinpatientswithcovid19
AT levasilyeva debatablepointsofusingangiotensinconvertingenzymeinhibitorsandangiotensinreceptorantagonistsinpatientswithcovid19