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Protective role of ACE inhibitors and ARBs in hypertensive patients suffering from COVID-19
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  • Dr. Arindam Talukdar,
  • Dipayan Sarkar,
  • Subhasis Roychowdhury,
  • Dipyaman Ganguly
Dr. Arindam Talukdar
Indian Institute of Chemical Biology CSIR
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Dipayan Sarkar
Indian Institute of Chemical Biology CSIR
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Subhasis Roychowdhury
AMRI Hospitals Saltlake Annexe
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Dipyaman Ganguly
Indian Institute of Chemical Biology CSIR
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Abstract

There is a renewed interest in the Renin-angiotensin system (RAS) as the coronavirus SARS-CoV2 enters the human body through the host ACE2 receptor. The infection is associated with down regulation of ACE2 leading to the imbalance in the RAS. We provided mechanistic insight on immunopathology of COVID-19 with respect to innate immune activation and ensuing adaptive immune response resulting in production of viral antigen-specific antibodies. The mini-review tries to drive home the anti-inflammatory role of ACEI/ARBs as an attractive treatment option in hypertensive or heart failure patients suffering from COVID19. The hypothesis is based on the available evidence of favorable immuno-mechanistic and clinical outcome data. The review tinkers with the immuno-mechanistic pathway with a probable role type I IFN response in case of SARS-CoV2, which is not yet clear. The review interconnected the role of principal players involved in RAS such as Angiotensin-converting enzyme (ACE), ACE2, decapeptide angiotensin I (ANG I), octapeptide angiotensin II (ANG II), heptapeptide angiotensin-(1–7), nonapeptide angiotensin-(1–9), ACE inhibitors (ACEI), AT1R blockers (ARBs) with respect to cardiovascular physiology and pathology.