Is the use of RAS inhibitors safe in the current era of COVID-19 pandemic?

2019 novel coronavirus ACE inhibitor ACE2 Angiotensin receptor blocker Antihypertensive drugs COVID-19 Hypertension Infection Pandemic SARS SARS-CoV-2 Sepsis

Journal

Clinical hypertension
ISSN: 2056-5909
Titre abrégé: Clin Hypertens
Pays: England
ID NLM: 101669508

Informations de publication

Date de publication:
2020
Historique:
received: 24 03 2020
accepted: 02 04 2020
entrez: 12 5 2020
pubmed: 12 5 2020
medline: 12 5 2020
Statut: epublish

Résumé

Antihypertensive drugs are one of the most widely used pharmacologic agent in the world and it is predominantly used in the elderly subjects. Pneumonia is the most common cause of death in the extremely old subject. During infection and its complication such as sepsis, hypotension could be exacerbated by antihypertensive drugs because homeostasis mechanisms such as sodium balance, renin angiotensin aldosterone system and/or sympathetic nervous system can be mitigated by antihypertensive drug therapy. Severe Acute Respiratory Syndrome-Coronavirus-1 and 2 viral surface protein is known to attach angiotensin converting enzyme 2 (ACE2) on the cell membrane to facilitate viral entry into the cytoplasm. Despite the theoretical concerns of increased ACE2 expression by Renin-Angiotensin-Aldosterone system (RAS) blockade, there is no evidence that RAS inhibitors are harmful during COVID-19 infection and have in fact been shown to be beneficial in animal studies. Therefore, it is recommended to maintain RAS blockade during the current corona virus pandemic.

Identifiants

pubmed: 32391169
doi: 10.1186/s40885-020-00144-0
pii: 144
pmc: PMC7202902
doi:

Types de publication

Journal Article Review

Langues

eng

Pagination

11

Informations de copyright

© The Author(s) 2020.

Déclaration de conflit d'intérêts

Competing interestsPark S received honoraria from Dai ichi Sankyo, Servier, Takeda, Boryung pharmaceutical company, Daewoong and Dong-A ST. HY Lee received honoraria from Dai ichi Sankyo, Servier, Takeda, Boryung Pharm., Daewoong, and Dong-A ST; DH Kim received honoraria from Sankyo, Servier, Takeda, Boryung Pharm., Daewoong, and Dong- ST; IS Sohn received grants from Hanmi. Pharm. and honoraria form Sankyo, Boryung, and Dong-A ST; WJ Chung received honoraria from Norvatis, Servier, Dong-A ST, Takeda, Boryung, and Hanmi Pharm.; J Shin received grants from Hanmi Pharm. and Sanifi and honoraria from Sankyo, Boryung, and Menarini. EJ Cho, KC Sung, J Kim, SH Ihm, K Kim, SK Ryu, WB Pyun, and HC Kim have no conflicts of interest.

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Auteurs

Sungha Park (S)

1Division of Cardiology, Severance Cardiovascular Hospital and Severance Cardiovascular Hospital and Integrated Research Center for Cerebrovascular and Cardiovascular diseases, Yonsei University College of Medicine, Seoul, South Korea.

Hae Young Lee (HY)

2Division of Cardiology, Department of Internal Medicine, Seoul National University Hospital, Seoul, South Korea.

Eun Joo Cho (EJ)

3Division of Cardiology, Department of Internal Medicine, Yeouido St. Mary's Hospital., College of Medicine, The Catholic University of Korea, Seoul, South Korea.

Ki Chul Sung (KC)

4Division of Cardiology, Department of Internal Medicine, Kangbuk Samsung Hospital, Seoul, South Korea.

Juhan Kim (J)

5Division of Cardiology, Department of Internal Medicine, Chonnam National University Hospital, Gwangju, South Korea.

Dae-Hee Kim (DH)

6Department of Cardiology, Asan Medical Center, College of Medicine, Ulsan University, Seoul, South Korea.

Sang-Hyun Ihm (SH)

7Division of Cardiology, Department of Internal Medicine, Bucheon St. Mary's Hospital., College of Medicine, The Catholic University of Korea, Seoul, South Korea.

Kwang-Il Kim (KI)

8Division of Geriatrics, Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, South Korea.

Il-Suk Sohn (IS)

9Division of Cardiology, Department of Internal Medicine, Kyung Hee University at Gangdong, Seoul, South Korea.

Wook-Jin Chung (WJ)

10Division of Cardiology, Department of Internal Medicine, Gil Hospital, Gachon University, Incheon, South Korea.

Hyeon Chang Kim (HC)

11Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, South Korea.

Sung Kee Ryu (SK)

12Division of Cardiology, Department of Internal Medicine, Nowon Eulji Medical Center, Eulji University, Seoul, South Korea.

Wook Bum Pyun (WB)

13Division of Cardiology, Department of Internal Medicine, Ewha Womans University Seoul Hospital, Seoul, South Korea.

Jinho Shin (J)

14Division of Cardiology, Department of Internal Medicine, Hanyang University Medical Center, 222 Wangsimni-ro Sungdong-gu, Seoul, South Korea.

Classifications MeSH