ACE drugs may benefit COVID-19 patients

Angiotensin-converting enzyme inhibitors (ACEi) or angiotensin receptor blockers (ARBs), do not appear to adversely impact patients with COVID-19, and may in fact be beneficial according to a recent meta-analysis published in Current Atherosclerosis Reports.

Because COVID-19 enters cells via the ACE receptor concern has been raised that people taking ACE drugs might be at increased risk.

The meta-analysis included studies involving 28 872 patients. The use of any ACE drugs for any conditions including hypertension, kidney failure or heart failure showed a trend to lower risk of death/critical events (odds ratio [OR] 0.671, confidence interval [CI] 0.435–1.034, p=0.071). For patients taking the drugs for hypertension, however, there was a significant lower association with deaths (OR 0.664, CI 0.458­–0.964, p=0.031) or the combination of death/critical outcomes (OR 0.670, CI 0.495–0.908, p=0.010).

According to the authors their meta-analysis showed no association between the use of ACEi/ARB and the severity and mortality among patients with COVID-19, but did find evidence of beneficial effects in hypertensive patients. While not advocating use of the drugs to potentially ameliorate COVID-19 effects they strongly recommend patients to continue with ACE inhibitor/blocker pharmacotherapy during the COVID-19 pandemic.

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