COVID-19 outbreak: continue ARBs and ACE inhibitors, GPs urged

Prescribers should not stop angiotensin receptor blockers (ARBs) or ACE inhibitors over COVID-19 concerns, the European Cardiology Society and the UK Renal Association have advised.

There is no evidence ACE inhibitors or angiotensin II antagonists are harmful in COVID-19. | DR P. MARAZZI/SCIENCE PHOTO LIBRARY
There is no evidence ACE inhibitors or angiotensin II antagonists are harmful in COVID-19. | DR P. MARAZZI/SCIENCE PHOTO LIBRARY

Concerns had been raised that ACE inhibitors and ARBs could increase the risk of coronavirus infection and the severity of COVID-19 disease, following the publication of correspondence in The Lancet Respiratory Medicine suggesting patients with hypertension and diabetes mellitus are at increased risk of COVID-19 infection. The virus has been shown to bind to the enzyme ACE2 to infect cells, and the authors pointed out that ACE2 levels are increased following treatment with drugs from these classes.

Further information

View ACE inhibitor and ARB drug records
ESC position statement MIMS Coronavirus Clinic

However, European and US cardiology societies and the UK Renal Association have issued statements reassuring prescribers that there is no convincing evidence that the medications are harmful in the context of the COVID-19 pandemic. They say reports linking the drugs to poor outcomes may simply reflect the fact that people taking them are more likely to have conditions that place them at high risk of severe COVID-19 infection.

Studies in animals suggest that ARBs and ACE inhibitors might even protect against serious lung complications in patients with COVID-19 infection, said the European Cardiology Society.

In the US, the American Heart Association, the Heart Failure Society of America, and the American College of Cardiology (ACC) also issued a joint statement noting that there is 'no experimental or clinical data demonstrating beneficial or adverse outcomes among COVID-19 patients using ACE-i or ARB medications'.

Want news like this straight to your inbox?
Sign up for our bulletins

Have you registered with us yet?

Register now to enjoy more articles and free email bulletins

Register
Already registered?
Sign in