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ACE inhibitors and COVID-19: we don’t know yet
  • Taqua Khashkhusha,
  • Jeffrey Chan,
  • Amer Harky
Taqua Khashkhusha
University of Liverpool
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Jeffrey Chan
The Chinese University of Hong Kong
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Amer Harky
Liverpool Heart and Chest Hospital NHS Trust
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Abstract

The SARS-CoV-2, the causative agent of COVID-19, has been established to gain access to the human cell via the ACE2 receptor similar to its familial coronavirus SARS-CoV which led to the outbreak in 2003. A concern with the newer 2019 coronavirus is its 10-20-fold higher affinity to the ACE2 receptor that of SARS-CoV, aiding its effective human-to-human transmission which has led to this pandemic. ACE2 receptor expression is thought to be upregulated in use with ACE inhibitors. As ACE inhibitors are known to be a used extensively in the treatment of hypertension it was a concern regarding the risk of using these medications alongside a SARS-COV-2 infection. ACE inhibitors are also used in the treatment regime of other common conditions including diabetes and Cardiovascular disease (CVD). It is worth noting that ACE2 expression has found to be upregulated by the use of thiazolidinediones and ibuprofen too. Consequently, the increased expression of ACE2 would facilitate infection with COVID-19. Therefore, it would hypothesise that diabetes and hypertension treatment with ACE2-stimulating drugs would increase the risk of developing severe and fatal COVID-19.

Peer review status:ACCEPTED

15 Apr 2020Submitted to Journal of Cardiac Surgery
16 Apr 2020Assigned to Editor
16 Apr 2020Submission Checks Completed
16 Apr 2020Reviewer(s) Assigned
16 Apr 2020Review(s) Completed, Editorial Evaluation Pending
16 Apr 2020Editorial Decision: Accept