Coronavirus Disease 2019 and Hypertension: The Role of Angiotensin-Converting Enzyme 2 and the Renin-Angiotensin System.
Adv Chronic Kidney Dis
; 27(5): 404-411, 2020 09.
Article
in English
| MEDLINE | ID: covidwho-722379
ABSTRACT
Hypertension emerged from early reports as a potential risk factor for worse outcomes for persons with coronavirus disease 2019 (COVID-19). Among the putative links between hypertension and COVID-19 is a key counter-regulatory component of the renin-angiotensin system (RAS) angiotensin-converting enzyme 2 (ACE2). ACE2 facilitates entry of severe acute respiratory syndrome coronavirus 2, the virus responsible for COVID-19, into host cells. Because RAS inhibitors have been suggested to increase ACE2 expression, health-care providers and patients have grappled with the decision of whether to discontinue these medications during the COVID-19 pandemic. However, experimental models of analogous viral pneumonias suggest RAS inhibitors may exert protective effects against acute lung injury. We review how RAS and ACE2 biology may affect outcomes in COVID-19 through pulmonary and other systemic effects. In addition, we briefly detail the data for and against continuation of RAS inhibitors in persons with COVID-19 and summarize the current consensus recommendations from select specialty organizations.
Keywords
Full text:
Available
Collection:
International databases
Database:
MEDLINE
Main subject:
Angiotensin-Converting Enzyme Inhibitors
/
Acute Lung Injury
/
Angiotensin Receptor Antagonists
/
Angiotensin-Converting Enzyme 2
/
COVID-19
/
Hypertension
Type of study:
Observational study
/
Prognostic study
Limits:
Humans
Language:
English
Journal:
Adv Chronic Kidney Dis
Journal subject:
Nephrology
Year:
2020
Document Type:
Article
Affiliation country:
J.ackd.2020.07.002
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