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Minerva Cardioangiologica 2020 August;68(4):339-46

DOI: 10.23736/S0026-4725.20.05271-8

Copyright © 2020 EDIZIONI MINERVA MEDICA

lingua: Inglese

Relationship between angiotensin-converting enzyme inhibitors, angiotensin II receptor blockers and SARS-CoV-2 infection: where are we?

Fabio INFUSINO 1 , Sara CIMINO 1, Marco LOMBARDI 2, Massimo MANCONE 1, Elena CAVARRETTA 3, 4, Giacomo FRATI 3, 5, Francesco PUGLIESE 6, Francesco FEDELE 1, Giuseppe BIONDI ZOCCAI 3, 4

1 Department of Clinical Internal, Anesthesiologic and Cardiovascular Sciences, Sapienza University, Rome, Italy; 2 Department of Cardiovascular and Thoracic Sciences, Sacred Heart Catholic University, Rome, Italy; 3 Department of Medico-Surgical Sciences and Biotechnologies, Sapienza University, Latina, Italy; 4 Mediterranea Cardiocenter, Naples, Italy; 5 IRCCS NEUROMED Institute, Pozzilli, Isernia, Italy; 6 Paride Stefanini Department of General Surgery and Surgical Specialties, Sapienza University, Rome, Italy



In recent months SARS-CoV-2 has spread rapidly throughout the world. The case fatality rate is higher in cardiovascular disease and hypertension. Other comorbidities do not seem to confer the same risk, therefore the understanding of the relationship between infection and cardiovascular system could be a crucial point for the fight against the virus. A great interest is directed towards the angiotensin 2 converting enzyme (ACE 2) which is the SARS-CoV-2 receptor and creates important connections between the virus replication pathway, the cardiovascular system and blood pressure. All cardiovascular conditions share an imbalance of the renin angiotensin system in which ACE 2 plays a central role. In the early pandemic period, much confusion has appeared about the management of therapy with angiotensin converting enzyme inhibitors and angiotensin receptor blockers especially in infected patients and in those at risk of critical illness in case of infection. In this article we will try to reorder the major opinions currently emerging on this topic.


KEY WORDS: COVID-19; Angiotensin-converting enzyme inhibitors; Cardiovascular diseases

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