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[Hypertension, RAAS blockade and risk in COVID-19 patients]

Jonas Spaak1, Thomas Kahan2

  • 1docent, bitr överläkare, ordförande i Svensk förening för hypertoni, stroke och vaskulär medicin, hjärtkliniken, Danderyds sjukhus.

Lakartidningen
|June 29, 2020
PubMed

Insights

This review finds no increased risk for patients on renin-angiotensin system (RAS) blockade during COVID-19. Current recommendations support continuing these vital medications for hypertension and heart conditions.

Area of Science:

  • Cardiovascular Medicine
  • Infectious Diseases
  • Pharmacology

Background:

  • SARS-CoV-2 utilizes ACE2 for host cell entry, the target of RAAS-blocking medications.
  • The safety of renin-angiotensin system (RAS) blockade in COVID-19 patients remains a significant clinical question.

Purpose of the Study:

  • To review the current evidence regarding the role of ACE inhibitors and ARBs in COVID-19 patients.
  • To inform clinical practice and recommendations for managing patients on RAAS blockade during the pandemic.

Main Methods:

  • Review of well-conducted observational studies.
  • Analysis of existing clinical data on COVID-19 outcomes in patients using RAAS blockade.

Main Results:

  • Multiple observational studies indicate no elevated risk associated with RAAS blockade in COVID-19.
  • Evidence suggests continued use of these medications does not worsen COVID-19 prognosis.

Conclusions:

  • Ongoing RAAS blockade should be maintained in patients with COVID-19.
  • The Swedish Society of Hypertension, Stroke and Vascular Medicine endorses current guidelines supporting RAAS blockade continuation.

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