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ACE Inhibitors, ARBs Not Linked to Risk for COVID-19

Last Updated: May 05, 2020.

Use of angiotensin-converting enzyme inhibitors or angiotensin-receptor blockers and other classes of antihypertensive medications seem not to be associated with COVID-19, according to two studies published online May 1 in the New England Journal of Medicine.

TUESDAY, May 5, 2020 (HealthDay News) -- Use of angiotensin-converting enzyme (ACE) inhibitors or angiotensin-receptor blockers (ARBs) and other classes of antihypertensive medications seem not to be associated with COVID-19, according to two studies published online May 1 in the New England Journal of Medicine.

Giuseppe Mancia, M.D., from the University of Milano-Bicocca in Italy, and colleagues conducted a case-control study in Lombardy, Italy, that included 6,272 case patients with severe acute respiratory syndrome coronavirus 2 infection and 30,759 matched controls. The researchers found that compared with controls, case patients more often had use of ACE inhibitors and ARBs, as well as use of other antihypertensive and nonantihypertensive drugs; case patients had a worse clinical profile. There was no association seen for use of ARBs or ACE inhibitors with COVID-19 among case patients overall or among those with a severe or fatal course of the disease.

Harmony R. Reynolds, M.D., from the New York University Grossman School of Medicine in New York City, and colleagues examined the association between previous treatment with ACE inhibitors, ARBs, beta-blockers, calcium-channel blockers, or thiazide diuretics and the likelihood of a positive or negative result of COVID-19 testing. Among 12,594 patients who were tested for COVID-19, 46.8 percent were positive and 17.0 percent of these had severe illness. The researchers found that 34.6 percent of the patients had a history of hypertension, and of these, 59.1 percent had a positive test; 24.6 percent of these had severe illness. No association was seen between any single antihypertensive medication class and an increased likelihood of a positive test or of severe illness among those who tested positive.

"Ultimately, one or more randomized trials will be needed to answer definitively the question of whether ACE inhibitors or ARBs pose a harm to patients with COVID-19," write the authors of an accompanying editorial.

Authors from both studies disclosed financial ties to the pharmaceutical industry.

Abstract/Full Text - Mancia
Abstract/Full Text - Reynolds
Editorial


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