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Association between COVID-19 and angiotensin-converting enzyme inhibitors with the spotlight on zinc: an opinion

Bashar Khiatah1, Amylee Amos2, Deborah Carlson3

  • 1Department of Internal Medicine, Community Memorial Hospital, Ventura, CA, USA.

Annals of Medicine
|September 24, 2021
PubMed

Insights

Chronic ACE inhibitor use may worsen COVID-19 severity by causing zinc deficiency. Further research is needed to confirm this link and assess zinc levels in affected patients.

Area of Science:

  • Pharmacology
  • Infectious Diseases
  • Nutritional Science

Background:

  • The COVID-19 pandemic necessitates the identification of novel therapeutics and a deeper understanding of disease pathophysiology.
  • Concerns exist regarding medications potentially exacerbating COVID-19 severity, with ACE inhibitors investigated for their role in ACE2 upregulation.
  • Nutrient-pharmaceutical interactions warrant exploration as potential mechanisms influencing disease outcomes.

Purpose of the Study:

  • To investigate the potential role of zinc insufficiency, induced by ACE inhibitors, in exacerbating COVID-19 severity.
  • To explore alternative mechanisms beyond ACE2 upregulation through which ACE inhibitors might impact COVID-19 patients.

Main Methods:

  • This paper discusses a hypothesis based on existing knowledge of nutrient-pharmaceutical interactions.
  • It reviews the potential for ACE inhibitors to induce zinc deficiency.
  • It posits this deficiency as a factor in COVID-19 pathogenicity.

Main Results:

  • Chronic use of ACE inhibitors may lead to zinc deficiency.
  • Zinc deficiency could potentially exacerbate the pathogenicity of COVID-19 in susceptible individuals.
  • This mechanism offers an alternative explanation for observed associations between ACE inhibitors and COVID-19 severity.

Conclusions:

  • Zinc deficiency, potentially caused by ACE inhibitors, is a plausible factor contributing to severe COVID-19 outcomes.
  • Further investigation, including multi-center studies, is crucial to assess zinc levels in COVID-19 patients using ACE inhibitors.
  • Understanding these interactions can inform clinical practice and therapeutic strategies during the pandemic.
Keywords:
ACEICOVID-19Critical CareNutritionSARS-CoV-2Zinc

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