Potential harmful effects of discontinuing ACE-inhibitors and ARBs in COVID-19 patients

eLife

Gian Paolo Rossi¹  Viola Sanga²  Matthias Barton³ 

[1] Hypertension Unit -Department of Medicine-DIMED, University of Padova, Padova, Italy;International PhD Program in Arterial Hypertension and Vascular Biology (ARHYVAB)- University of Padua, Padua, Italy;University of Zürich, Zürich, Switzerland;

关键词: SARS-CoV-2;    ACEIs;    ARBs;    ACE-2;    treatment;    ARDS;   

DOI  :  10.7554/eLife.57278

来源: DOAJ

【 摘 要 】

The discovery of angiotensin converting enzyme-2 (ACE-2) as the receptor for SARS- CoV-2 (Severe Acute Respiratory Syndrome Coronavirus-2) has implicated the renin-angiotensin-aldosterone system in acute respiratory distress syndrome (ARDS) and respiratory failure in patients with coronavirus disease-19 (COVID-19). The angiotensin converting enzyme-1–angiotensin II–angiotensin AT1 receptor pathway contributes to the pathophysiology of ARDS, whereas activation of the ACE-2–angiotensin(1-7)-angiotensin AT2 receptor and the ACE-2–angiotensin(1-7)–Mas receptor pathways have been shown to be protective. Here we propose and discuss therapeutic considerations how to increase soluble ACE-2 in plasma in order for ACE-2 to capture and thereby inactivate SARS-CoV-2. This could be achieved by administering recombinant soluble ACE-2. We also discuss why and how ACEIs and ARBs provide cardiovascular, renal and also pulmonary protection in SARS-CoV-2- associated ARDS. Discontinuing these medications in COVID-19 patients may therefore potentially be harmful.

【 授权许可】

Unknown