Abstract

MONTANO, Luis M.  and  FLORES-SOTO, Edgar. COVID-19 and its Association with Angiotensin-Converting Enzyme Inhibitors and Angiotensin II Receptor Antagonists. Rev. Fac. Med. (Méx.) [online]. 2020, vol.63, n.4, pp.30-34.  Epub Mar 05, 2021. ISSN 2448-4865.  https://doi.org/10.22201/fm.24484865e.2020.63.4.05.

Worldwide, over 7 million people have been infected due to the pandemic of COVID-19. The comorbidities associated to this disease are: hypertension, diabetes mellitus, obesity, obstructive pulmonary disease (COPD), cardiovascular disease, chronic renal failure, smoking, immunosuppression, and hypertension. Angiotensin-converting enzyme 2 (ACE2) is the functional receptor for SARS-CoV-2. This virus has an S protein that recognizes ACE2 as its receptor to enter the cell. ACE2 is a plasmatic protein expressed in alveolar cells type I, II, fibroblasts, endothelial cells and macrophages. Treatment with inhibitors of the angiotensin-converting enzyme (ACEi) or the receptor antagonist for angiotensin II (ARBs) notably increase the expression of ACE2. Therefore, in patients with these pathologies and treated with these medicines, the risk of developing the COVID-19 in a severe and fatal way could be increased. In Mexico, the major mortality due to COVID-19 is related to hypertension, diabetes mellitus, obesity and being over 65 years of age. Therefore, we suggest that during the SARS-CoV-2 pandemic, patients with hypertension treated with ACEi or ARBs, should receive alternative treatments such as L-type Ca2+ channel blockers (amlodipine) that have not been associated with ACE2 until now.

Keywords : COVID-19; SARS-CoV-2; captopril; losartan hypertension.