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Review
. 2020 May;145(10):682-686.
doi: 10.1055/a-1152-3469. Epub 2020 Apr 22.

[Renin-Angiotensin-System (RAS) and COVID-19 - On The Prescription of RAS Blockers]

[Article in German]
Free article
Review

[Renin-Angiotensin-System (RAS) and COVID-19 - On The Prescription of RAS Blockers]

[Article in German]
Reinhold Kreutz et al. Dtsch Med Wochenschr. .
Free article

Abstract

Twenty years ago, an enzyme homologous to the previously known angiotensin-converting enzyme (ACE) was identified, and subsequently named ACE2. In the renin-angiotensin system (RAS), ACE2 has counter-regulatory functions against the classical effector peptide angiotensin II, for example in blood pressure regulation and cardiovascular remodeling. However, ACE2 provides an initially unexpected interesting link between virology and cardiovascular medicine. That is, ACE2 represents the binding receptor for the cellular uptake of SARS-CoV and SARS-CoV-2 viruses. Thus, ACE2 is relevant for COVID-19. In this context, it was suspected that therapy with RAS blockers might promote transmission and complications of COVID-19 by upregulation of ACE2 expression. The aim of this short review is, to describe the link between the RAS, particularly ACE2, and COVID-19. Based on our analysis and evaluation of the available findings, we justify our conclusion: important drugs such as ACE inhibitors and angiotensin receptor blockers should continue to be prescribed according to guidelines to stable patients in the context of the COVID-19 pandemic.

Conflict of interest statement

Reinhold Kreutz hat Honorare für Vortragstätigkeit, Beratertätigkeit oder Unterstützung für Forschung erhalten von Bayer Pharma, Berlin-Chemie Menarini, Daiichi Sankyo, Ferrer, Sanofi, Servier außerhalb der aktuellen Arbeit.

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