RAS and SARS-CoV-2 interaction: short review of the latest evidence

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Abstract

Coronavirus SARS-CoV-2 is responsible for the coronavirus disease (COVID-19) cause of the recent global pandemic, which is causing thousands of deaths worldwide and represents a health challenge with few precedents in human history. The angiotensin 2 conversion enzyme (ACE-2) has been identified as the receptor that facilitates access to SARS-CoV-2 in cells; evidence shows that its concentration varies during the various stages of viral infection. Therapeutic agents modifying the renin-angiotensin system (RAS) may be able to modulate the concentration of ACE-2 and the various components of the system. In this article we examine the latest evidence on the association between the use of RAS modifying agents and coronavirus 2019 (COVID-19) disease caused by SARS-CoV-2. Our investigation and critical literature research does not suggest discontinuation of ACEIs/ARBs treatment in clinical practice as there is a lack of robust evidence. However, we recommend further well-structured epidemiological studies investigating this sensitive issue that may provide important new suggestions for implementing guidelines.

About the authors

A. Vitiello

Ministry of Health

Email: ferrarafr@libero.it

Clinical Pharmacologist

Italy, Rome

Francesco Ferrara

Asl Napoli 3 Sud

Author for correspondence.
Email: ferrarafr@libero.it

Hospital Pharmacist Manager, Pharmaceutical Department

Italy, Naples

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