ESC Position statement on continued ACEi and ARBs use in relation to coronavirus COVID-19 outbreak

The ESC Council on Hypertension has released a statement, strongly recommending to continue treatment of ACEi and ARBs in times of the COVID-19 pandemic, as evidence for harmful effects of these drugs in context of COVID-19 is lacking.

The Council of Hypertension of the ESC has released a position statement on the recommended continued use of ACEi and ARBs, as there is no clinical or scientific evidence that treatment with these anti-hypertensive drugs should be discontinued in those infected with the COVID-19 coronavirus.

It has been suggested that ACEi or ARBs may have potential adverse effects in hospitalized COVID-19 infected subject and that ACEi and ARBs may increase risk of infection and severity of infection. These concerns are based on the observation that SARS-CoV-2, the virus that causes COVID-19, binds to the angiotensin converting enzyme 2 (ACE2) receptor and a few experimental studies have shown that ACE2 levels are upregulated in the heart with ACEi and ARBs treatment.

Some patients and doctors have become concerned (also due to amplification of this message by social media) and have stopped taking ACEi or ARB medication. The ESC Council of Hypertension would like to stress though that this speculation of unsafety of ACEi or ARBS in relation to COVID-19 is not evidence-based. On the contrary, there is evidence from animal studies suggesting that these therapies are protective against serious lung complication in COVID-19 infected patients.

Source: ESC Position Statement of the ESC Council on Hypertension, March 13, 2020HFSA/ACC/AHA statement on RAASi use in COVID-19