Anti hypertensive agents in patients with COVID-19. Revista Chilena de Cardiología (2020)

Andrea Ramírez-Sagredo, Andrés Ramírez-Reyes, María Paz Ocaranza, Mario Chiong, Jaime A. Riquelme, Jorge E. Jalil, Sergio Lavandero.

On December 31, 2019, the World Health Organization (WHO) was informed by the Chinese health authorities of the appearance of cases of pneumonia of unknown origin in the city of Wuhan and 7 days later, scientists identified the biological agent as a new coronavirus. causing the COVID-19 disease. The sequencing of its genetic material (RNA or ribonucleic acid) revealed its relationship with Severe Acute Respiratory Syndrome (SARS) and this new coronavirus was baptized SARS-CoV-2, which to date is responsible for the serious pandemic it is causing health and socio-economic impacts on a global scale. Investigations with SARS-CoV-2 established that

This virus enters our cells using the Angiotensin Converting Enzyme Type 2 (ACE-2: “angiotensin converting enzyme type 2”) as a receptor. ECA-2 is a protease integral to the renin angiotensin system “alternate or non-canonical” that regulates the cardiovascular, renal and pulmonary systems, among others. In this context, concerns have been raised by both clinicians and hypertensive patients themselves regarding their vulnerability to becoming infected with SARS-CoV-2. Some preclinical studies have suggested that certain antihypertensive drugs could stimulate a greater expression of ACE-2, that is, a greater presence of this receptor in patients who consume these drugs as part of their treatment. The purpose of this review is to present and discuss the background in the state of the art regarding this recent problem. The critical analysis of the present antecedents allows us to conclude that there is no solid clinical evidence that allows us to affirm that the use of antihypertensive drugs generates a greater vulnerability to infection with SARS-CoV-2. Therefore its use should not be discontinued in hypertensive patients at risk of contagion with SARS-CoV-2 or who develop COVID-19 disease.