The Potential Role of ACEi and ARBs in COVID-19; A Perspective

ABSTRACT. COVID-19 pandemic has caused significant morbidity and mortality around the world. The disease severity ranges from mild upper respiratory infection to severe lower respiratory and cardiac illness. Acute respiratory distress syndrome (ARDS) is the most serious complication and results in diffuse inflammatory alveolar damage, respiratory failure, and death. Components of the Renin -Angiotensin-Aldosterone -System (RAAS) are involved in an inflammatory reaction in the lungs. Various studies have shown that blocking RAAS peptides in the lungs especially angiotensin-converting enzyme (ACE) and type-1 angiotensin receptor (ATR1) reduces lung injury, improves respiratory function and is associated with better clinical outcomes in the COVID-19 patients. We suggest that angiotensin-converting enzyme inhibitors (ACEi) and angiotensin receptor blockers (ARBs) – drugs that block RAAS peptides – be considered for a repurposed use in COVID-19 induced lung injury.