Inhibitors of the Renin–Angiotensin–Aldosterone System and Covid-19

This editorial examines the ongoing debate around the safety of renin–angiotensin–aldosterone system (RAAS) inhibitors such as ACE inhibitors and ARBs in the context of Covid-19. Early hypotheses suggested these drugs might upregulate ACE2, the viral entry receptor for SARS-CoV-2, potentially worsening outcomes. However, three large observational studies reviewed in the article consistently found no evidence that continued use of ACE inhibitors or ARBs increased the risk of infection, severe disease, or death. The authors caution against altering therapy based on unproven theories and emphasize the importance of maintaining cardiovascular care while awaiting randomized trial data.

This editorial examines the ongoing debate around the safety of renin–angiotensin–aldosterone system (RAAS) inhibitors such as ACE inhibitors and ARBs in the context of Covid-19. Early hypotheses suggested these drugs might upregulate ACE2, the viral entry receptor for SARS-CoV-2, potentially worsening outcomes. However, three large observational studies reviewed in the article consistently found no evidence that continued use of ACE inhibitors or ARBs increased the risk of infection, severe disease, or death. The authors caution against altering therapy based on unproven theories and emphasize the importance of maintaining cardiovascular care while awaiting randomized trial data.