Quality of evidence: C
Can angiotensin receptor-blocking drugs perhaps be harmful in the COVID-19 pandemic?
Authors: Murray E et al
Journal: Journal Of Hypertension
Objectives: Describe the possible impact of antihypertensive drugs
Strength of evidence: Low (letter to the editor, hypothesis)
Methods/publication type: letter to the editor
Highlights :
Hypertension is a predictive factor for severity even though ACE2 (target of sars-cov-2 for entry) is usually lowered in hypertension models
Angiotensin receptor blockers (ARBs) might increase the risk for COVID-19 severity as they increase ACE2 levels (especially in kidneys and heart)
Suggest to focus on immunological antagonism of the binding site of SARS-CoV-2 spikes to ACE2 receptors
Prescribing ARB during the epidemic could, therefore, be harmful, other classes of antihypertensive drugs are preferred
No increase in ARB dosage or initiation of ARB treatment should be done in COVID19. In severe forms
ARB should perhaps be switched to other antihypertensive drugs
The decrease in ACE2 receptor expression after ARB discontinuation is unknown.
ACE-1 inhibitors and beta-blockers might diminish ACE-2 and thus SARS-COV2 infection
DO NOT STOP ARBs BEFORE CONFIRMATION OF THESE ASSUMPTIONS (Changing treatment = risk of blood pressure imbalance = higher risk for CVD events and possibly higher risk during COVID-19)
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