Abstract
We read with great interest the article by Khashkhusha TR et al “ACE
inhibitors and COVID-19: We don’t know yet”. The authors discuss
whether the use of angiotensin-converting enzyme (ACE) inhibitors
(ACEIs) in novel coronavirus disease‐19 (COVID‐19) patients is
beneficial or harmful. ACEIs and angiotensin receptor antagonists (ARBs)
both upregulate ACE2 levels. We believe that ARBs should be preferred
since, unlike ARBs, ACEIs may increase angiotensin II through the
chymase pathway. We would like to discuss potential harms ACEI may cause
through secondary bradykinin-chymase pathways.