Protective role of ACE inhibitors and ARBs in hypertensive patients
suffering from COVID-19
Abstract
There is a renewed interest in the Renin-angiotensin system (RAS) as the
coronavirus SARS-CoV2 enters the human body through the host ACE2
receptor. The infection is associated with down regulation of ACE2
leading to the imbalance in the RAS. We provided mechanistic insight on
immunopathology of COVID-19 with respect to innate immune activation and
ensuing adaptive immune response resulting in production of viral
antigen-specific antibodies. The mini-review tries to drive home the
anti-inflammatory role of ACEI/ARBs as an attractive treatment option in
hypertensive or heart failure patients suffering from COVID19. The
hypothesis is based on the available evidence of favorable
immuno-mechanistic and clinical outcome data. The review tinkers with
the immuno-mechanistic pathway with a probable role type I IFN response
in case of SARS-CoV2, which is not yet clear. The review interconnected
the role of principal players involved in RAS such as
Angiotensin-converting enzyme (ACE), ACE2, decapeptide angiotensin I
(ANG I), octapeptide angiotensin II (ANG II), heptapeptide
angiotensin-(1–7), nonapeptide angiotensin-(1–9), ACE inhibitors
(ACEI), AT1R blockers (ARBs) with respect to cardiovascular physiology
and pathology.