Abstract

VALLEJO ARDILA, Dora Lucía; TAMAYO CACERES, Yenny Rocío  and  MUNIVE, Abraham Alí. Therapeutic use of angiotensin converting enzyme inhibitors in patients with COVID-19: the “two sides of the coin”. Rev. Colomb. Cardiol. [online]. 2020, vol.27, n.4, pp.212-222.  Epub June 17, 2021. ISSN 0120-5633.  https://doi.org/10.1016/j.rccar.2020.07.001.

There is limited evidence for determining the impact of the use of angiotensin converting enzyme inhibitors (ACE-I) in the tendency to worsening of coronavirus-19 disease (COVID-19). It was initially reported that, in patients with serious progression of COVID-19, there was an increased mortality in those that had a history of suffering arterial hypertension, diabetes mellitus, cardiovascular disease, and chronic kidney disease. A proportion of these patients also had in common that they used ACE-I, which alerted the medical community on the potential risk in coexisting with COVID-19. However, in more recent case-control studies, they found that inhibitors of the renin-angiotensin system, including ACE-I, does not increase the risk of COVID-19 or require hospital admission due to this cause. Several scientific journals have provided access to preliminary reports, leaving the use of such information at the discretion of the medical and scientific community for promoting the development of studies that might confirm these preclinical and epidemiological findings experimentally. These may finally have an impact on the clinical practice decisions, in order to benefit patients with COVID-19. In this literature review, the different effects mediated by ACE-I that could be related to the immune response during the infection and transmission of COVID-19 are examined, gathering available evidence that evaluates whether, in reality, they represent a risk or if on the other hand, they confer a protector effect.

Keywords : Angiotensin Converting Enzyme Inhibitors; COVID-19; Cardiovascular disease; Renin-angiotensin system; Immunomodulatory effect; Immune response.

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