Relationship between ACE-inhibitors, ARBs and SARS-CoV-2 infection: where are we?

Fabio Infusino, Sara Cimino, Marco Lombardi, Massimo Mancone, Elena Cavarretta, Giacomo Frati, Francesco Pugliese, Francesco Fedele, Giuseppe Biondi-Zoccai

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SARS-CoV-2 is spreading rapidly all over the world. The case fatality rate seems 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 currently 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 (RAAS) in which ACE 2 plays a central role. In the last few days, much confusion has appeared about the management of therapy with angiotensin converting enzyme inhibitors (ACE-i) and angiotensin receptor blockers (ARBs) 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.

Original languageEnglish
JournalMinerva Cardioangiologica
Publication statusE-pub ahead of print - May 29 2020


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