ACE-Inhibitors and ARBs during COVID-19

Today’s pearl is about the use of ACE-Is and ARBs in patients with COVID-19

Should they be continued?

 Many are wondering if they should continue taking their angiotensin converting enzyme inhibitors (ACE-I) (eg, lisinopril) or angiotensin receptor blockers (ARB) (eg, losartan) for hypertension, heart failure, etc. during the COVID-19 pandemic.

The answer is YES! (Patel 2020)

As with all drug therapies being studied amid this pandemic, recommendations could change. There is ongoing research assessing the role of ACE2 in SARS-CoV-2 and whether ACE-Is or ARBs have an effect on outcomes.

The American Heart Association currently recommends continuing ACE-I or ARB therapy during COVID-19 (HFSA/ACC/AHA statement). If patients have concerns, they should talk to their prescriber before discontinuing.




Author: Bryan D. Hayes, PharmD

Attending Pharmacist, Emergency Medicine and Toxicology, Massachusetts General Hospital; Assistant Professor of EM, Harvard Medical School

One thought on “ACE-Inhibitors and ARBs during COVID-19”

  1. I have read two articles by Chinese scientists that indicate that the presence of ACE2 receptors may actually be fortuitous, which they understand is counter-intuitive since it is the binding site for the virus. The first of the two articles reported that Asian females with higher ACE2 expression fared considerably better when compared to Asian men with low levels of expression. I only recently learned that ACE2 is sex-linked. Could this have any implications for the seemingly greater incidence of Covid-19 in males?


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