RESUMEN
The first case of COVID-19 was reported on 31 December 2019 in Wuhan, China. Ever since there has been unprecedented and growing interest in learning about all aspects of this new disease. Debate has been generated as to the association between antihypertensive therapy with renin-angiotensin-aldosterone system (RAAS) inhibitors and SARS-CoV-2 infection. While many questions as yet remain unanswered, the aim of this report is to inform health professionals about the current state of knowledge. Because this is an ever-evolving topic, the recommendation is that it be updated as new evidence becomes available. Below, we provide a review of pre-clinical and clinical studies that link coronavirus to the RAAS.
Asunto(s)
Betacoronavirus , Infecciones por Coronavirus/fisiopatología , Pandemias , Neumonía Viral/fisiopatología , Sistema Renina-Angiotensina/fisiología , Proteína ADAM17/fisiología , Angiotensina II/fisiología , Antagonistas de Receptores de Angiotensina/efectos adversos , Antagonistas de Receptores de Angiotensina/farmacología , Antagonistas de Receptores de Angiotensina/uso terapéutico , Enzima Convertidora de Angiotensina 2 , Inhibidores de la Enzima Convertidora de Angiotensina/efectos adversos , Inhibidores de la Enzima Convertidora de Angiotensina/farmacología , Inhibidores de la Enzima Convertidora de Angiotensina/uso terapéutico , Antihipertensivos/efectos adversos , Antihipertensivos/farmacología , Antihipertensivos/uso terapéutico , COVID-19 , Vacunas contra la COVID-19 , Infecciones por Coronavirus/complicaciones , Infecciones por Coronavirus/inmunología , Infecciones por Coronavirus/prevención & control , Humanos , Hipertensión/complicaciones , Hipertensión/fisiopatología , Pulmón/fisiopatología , Modelos Biológicos , Pandemias/prevención & control , Peptidil-Dipeptidasa A/efectos de los fármacos , Peptidil-Dipeptidasa A/fisiología , Neumonía Viral/complicaciones , Neumonía Viral/inmunología , Neumonía Viral/prevención & control , Receptores Virales/efectos de los fármacos , Sistema Renina-Angiotensina/efectos de los fármacos , Síndrome de Dificultad Respiratoria/etiología , Síndrome de Dificultad Respiratoria/fisiopatología , SARS-CoV-2 , Serina Endopeptidasas/fisiología , Vacunas Virales , Internalización del Virus/efectos de los fármacosRESUMEN
The association between hypertension, diabetes, cardio and cerebrovascular disease and severe and fatal COVID-19, described in different countries, is remarkable. Myocardial damage and myocardial dysfunction are postulated as a possible causal nexus. Frequent findings of elevated troponin levels and electrocardiographic anomalies support this concept. On the other hand, hypotheses in favour and against a deleterious effect of angiotensin converting enzyme inhibitors and angiotensin receptor blockers, a usual treatment for cardiovascular disease, have been raised. There is currently no solid evidence and thus properly designed studies on this subject are urgently needed. In this context, patients with cardiovascular disease should especially avoid being exposed to the virus, should not self-medicate and rapidly seek medical advice should they show symptoms of infection.