Systematic review of the role of renin-angiotensin system inhibitors in late studies on Covid-19: A new challenge overcome?

[摘要] A role for the renin-angiotensin-aldosterone-systemin Severe Acute Respiratory Syndrome-Coronavirus-2 infection and in the development of COronaVIrus Disease-19 disease has generated remarkable concerns among physicians and patients. Even though a suggestive pathophysiological link between renin-angiotensin-aldosteronesystemand the virus has been proposed, its pathogenic role remains very difficult to be defined. Although COrona VIrus Disease-19 targets preferentially older peoplewith high prevalence of hypertension and extensive use of renin-angiotensin-aldosterone-system inhibitors, an independent role for hypertension and its therapies is not defined. In this article, we scrutinize evidence from themost representative available studies inwhich the potential role of renin-angiotensin systeminhibitors, specifically angiotensin-converting enzyme inhibitors and angiotensin receptor blockers, was evaluated in the COronaVIrus Disease-19 disease course, with regard to severity of the disease and mortality. We conclude that at this time, the overall available evidence fails to support a pathogenetic speaks against any harmful role for of renin-angiotensin-aldosterone-system inhibitors in COronaVIrus Disease-19. Consequently, we conclude that treatment with renin-angiotensin-aldosterone-system inhibitors should not be discontinued and, therefore, these therapies should not be interrupted. (C) 2020 Elsevier B.V. All rights reserved.

[发布日期] 2020-12-15

[关键词] Hypertension;Covid-19;Renin-angiotensin-aldosterone system;Angiotensin-converting enzyme inhibitors;Angiotensin receptor blockers