Impact of renin-angiotensin-aldosterone system inhibitors on COVID-19

Area of Science:

• Cardiovascular Research
• Infectious Diseases
• Pharmacology

Background:

• The coronavirus disease 2019 (COVID-19) pandemic raised questions about the role of renin-angiotensin system (RAS) inhibitors.
• Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) utilizes angiotensin-converting enzyme 2 (ACE2) for entry, potentially disrupting RAS balance and causing hyperinflammation.

Purpose of the Study:

• To review the current understanding of RAS inhibitors' effects in COVID-19.
• To summarize evidence on how RAS inhibitors interact with SARS-CoV-2 infection pathways.

Main Methods:

• Literature review of studies investigating RAS inhibitors and COVID-19.
• Analysis of the mechanisms by which SARS-CoV-2 affects the RAS and the potential counter-regulatory role of ACE inhibitors and ARBs.

Main Results:

• RAS inhibitors may inhibit SARS-CoV-2-induced RAS hyperactivation and increase ACE2 expression.
• Evidence suggests a potentially beneficial profile for RAS inhibitors in COVID-19, though findings are not definitive.

Conclusions:

• RAS inhibitors might mitigate COVID-19 severity by modulating the renin-angiotensin system.
• Further prospective studies are essential to establish the definitive role and clinical impact of RAS inhibitors in managing COVID-19.