Angiotensin-Converting Enzyme Inhibitors and Angiotensin-Receptor Blockers and COVID-19 (research up to 4 May 2020)

Added August 20, 2020

Citation: Mackey K, King VJ, Gurley S, et al. Risks and Impact of Angiotensin-Converting Enzyme Inhibitors or Angiotensin-Receptor Blockers on SARS-CoV-2 Infection in Adults: A Living Systematic Review. Annals of Internal Medicine. 2020;173(3):195-203.

What is this? Some patients with COVID-19 disease will be taking angiotensin-converting enzyme inhibitors (ACEIs) and angiotensin-receptor blockers (ARBs) for other conditions, so it is important to know if these affect COVID-19 disease susceptibility and severity.

In this living systematic review, the authors searched for studies that examined associations and effects of ACEIs or ARBs on risk for SARS-CoV-2 infection and COVID-19 disease severity and mortality in adults. They did not restrict their searches by language of publication and did the search for articles published between 1 January 2003 and 4 May 2020. They included 14 observational studies and identified 4 ongoing randomised trials testing ACEIs or ARBs as treatments for COVID-19.

What was found: At the time of this review, the included studies showed that ACEI or ARB use is not associated with more severe COVID-19 disease or a positive SARS-CoV-2 test result among symptomatic patients.

At the time of this review, the included studies showed that it is uncertain whether ACEIs or ARBs increase the risk of mild or asymptomatic COVID-19 disease or are beneficial for the treatment of COVID-19.


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