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COVID-19 and renin-angiotensin system inhibition: role of angiotensin converting enzyme 2 (ACE2) - Is there any scientific evidence for controversy?
J Intern Med. 2020 Oct; 288(4):410-421.JI

Abstract

Renin-angiotensin system (RAS) blockers are extensively used worldwide to treat many cardiovascular disorders, where they are effective in reducing both mortality and morbidity. These drugs are known to induce an increased expression of angiotensin-converting enzyme 2 (ACE2). ACE2 acts as receptor for the novel SARS coronavirus-2 (SARS-CoV-2) which raising the important issue of possible detrimental effects that RAS blockers could exert on the natural history and pathogenesis of the coronavirus disease-19 (COVID-19) and associated excessive inflammation, myocarditis and cardiac arrhythmias. We review the current knowledge on the interaction between SARS-CoV-2 infection and RAS blockers and suggest a scientific rationale for continuing RAS blockers therapy in patients with COVID-19 infection.

Authors+Show Affiliations

From the, Cardiothoracovascular Department, Azienda Sanitaria Universitaria Giuliano Isontina (ASUGI), University of Trieste, Trieste, Italy.From the, Cardiothoracovascular Department, Azienda Sanitaria Universitaria Giuliano Isontina (ASUGI), University of Trieste, Trieste, Italy.From the, Cardiothoracovascular Department, Azienda Sanitaria Universitaria Giuliano Isontina (ASUGI), University of Trieste, Trieste, Italy.From the, Cardiothoracovascular Department, Azienda Sanitaria Universitaria Giuliano Isontina (ASUGI), University of Trieste, Trieste, Italy.From the, Cardiothoracovascular Department, Azienda Sanitaria Universitaria Giuliano Isontina (ASUGI), University of Trieste, Trieste, Italy.From the, Cardiothoracovascular Department, Azienda Sanitaria Universitaria Giuliano Isontina (ASUGI), University of Trieste, Trieste, Italy.National Institute for Infectious Diseases Lazzaro Spallanzani - IRCCS, Rome, Italy.Division of Infection and Immunity, University College London, London, UK. National Institute of Health Research, Biomedical Research Centre, University College London Hospitals NHS Foundation Trust, London, UK.University of Udine, Udine, Italy.From the, Cardiothoracovascular Department, Azienda Sanitaria Universitaria Giuliano Isontina (ASUGI), University of Trieste, Trieste, Italy.

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't
Review

Language

eng

PubMed ID

32459372

Citation

Aleksova, A, et al. "COVID-19 and Renin-angiotensin System Inhibition: Role of Angiotensin Converting Enzyme 2 (ACE2) - Is There Any Scientific Evidence for Controversy?" Journal of Internal Medicine, vol. 288, no. 4, 2020, pp. 410-421.
Aleksova A, Ferro F, Gagno G, et al. COVID-19 and renin-angiotensin system inhibition: role of angiotensin converting enzyme 2 (ACE2) - Is there any scientific evidence for controversy? J Intern Med. 2020;288(4):410-421.
Aleksova, A., Ferro, F., Gagno, G., Cappelletto, C., Santon, D., Rossi, M., Ippolito, G., Zumla, A., Beltrami, A. P., & Sinagra, G. (2020). COVID-19 and renin-angiotensin system inhibition: role of angiotensin converting enzyme 2 (ACE2) - Is there any scientific evidence for controversy? Journal of Internal Medicine, 288(4), 410-421. https://doi.org/10.1111/joim.13101
Aleksova A, et al. COVID-19 and Renin-angiotensin System Inhibition: Role of Angiotensin Converting Enzyme 2 (ACE2) - Is There Any Scientific Evidence for Controversy. J Intern Med. 2020;288(4):410-421. PubMed PMID: 32459372.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - COVID-19 and renin-angiotensin system inhibition: role of angiotensin converting enzyme 2 (ACE2) - Is there any scientific evidence for controversy? AU - Aleksova,A, AU - Ferro,F, AU - Gagno,G, AU - Cappelletto,C, AU - Santon,D, AU - Rossi,M, AU - Ippolito,G, AU - Zumla,A, AU - Beltrami,A P, AU - Sinagra,G, Y1 - 2020/06/08/ PY - 2020/3/29/received PY - 2020/5/8/revised PY - 2020/5/12/accepted PY - 2020/5/28/pubmed PY - 2020/9/30/medline PY - 2020/5/28/entrez KW - ACEIs/ARBs KW - COVID-19 KW - RAAS KW - SARS coronavirus (CoV)-2 KW - angiotensin-converting enzyme 2 (ACE2) KW - cardiovascular system KW - pandemic SP - 410 EP - 421 JF - Journal of internal medicine JO - J Intern Med VL - 288 IS - 4 N2 - Renin-angiotensin system (RAS) blockers are extensively used worldwide to treat many cardiovascular disorders, where they are effective in reducing both mortality and morbidity. These drugs are known to induce an increased expression of angiotensin-converting enzyme 2 (ACE2). ACE2 acts as receptor for the novel SARS coronavirus-2 (SARS-CoV-2) which raising the important issue of possible detrimental effects that RAS blockers could exert on the natural history and pathogenesis of the coronavirus disease-19 (COVID-19) and associated excessive inflammation, myocarditis and cardiac arrhythmias. We review the current knowledge on the interaction between SARS-CoV-2 infection and RAS blockers and suggest a scientific rationale for continuing RAS blockers therapy in patients with COVID-19 infection. SN - 1365-2796 UR - https://www.unboundmedicine.com/medline/citation/32459372/COVID_19_and_renin_angiotensin_system_inhibition:_role_of_angiotensin_converting_enzyme_2__ACE2____Is_there_any_scientific_evidence_for_controversy DB - PRIME DP - Unbound Medicine ER -