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Minerva Cardioangiologica 2020 May 29

DOI: 10.23736/S0026-4725.20.05271-8

Copyright © 2020 EDIZIONI MINERVA MEDICA

lingua: Inglese

Relationship between ACE-inhibitors, ARBs 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 Cardiovascular, Respiratory, Nephrological, Aenesthesiological and Geriatric Sciences, Policlinico Umberto I, “Sapienza” University of Rome, Rome, Italy; 2 Department of Cardiovascular and Thoracic Sciences, Catholic University of the Sacred Heart, Rome, Italy; 3 Department of Medico-Surgical Sciences and Biotechnologies, “Sapienza” University of Rome, Latina, Italy; 4 Mediterranea Cardiocentro, Naples, Italy; 5 IRCCS NEUROMED, Località Camerelle, Pozzilli, Isernia, Italy; 6 Department of Anesthesia and Intensive Care Medicine, Policlinico Umberto I, “Sapienza” University of Rome, Rome, Italy


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SARS-CoV-2 is spreading rapidly all over the world. The case fatality rate seems 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 currently 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 (RAAS) in which ACE 2 plays a central role. In the last few days, much confusion has appeared about the management of therapy with angiotensin converting enzyme inhibitors (ACE-i) and angiotensin receptor blockers (ARBs) 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: SARS-CoV-2, COVID-19, ACE-inhibitors, ARBs, Cardiovascular disease

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