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Angiotensin-Converting Enzyme 2 and Anti-Hypertensives (Angiotensin
Receptor Blockers and Angiotensin Converting Enzyme Inhibitors) in
Coronavirus Disease 2019 (COVID-19)
Authors:
Fabian Sanchis-Gomar, MD, PhD; Carl J. Lavie, MD; Carme Perez-Quilis, MD, PhD;
Brandon M. Henry, MD; Giuseppe Lippi, MD.
Affiliations: From The Department of Physiology, Faculty of Medicine, University of Valencia andINCLIVA Biomedical Research Institute, Valencia, Spain (F.S.-G., C.P.-Q.) and Division of CardiovascularMedicine, Stanford University School of Medicine, Stanford, California, USA (F.S.-G.); John Ochsner Heartand Vascular Institute, Ochsner Clinical School - The University of Queensland School of Medicine, NewOrleans, LA, USA (C.J.L.); Cardiac Intensive Care Unit, The Heart Institute, Cincinnati Children’s HospitalMedical Center, Ohio, USA (B.M.H.); Section of Clinical Biochemistry, University of Verona, Verona, Italy(G.L.).
¶ B.M.H. and G.L. share senior authorship in this work
Correspondence: Fabian Sanchis-Gomar, MD, PhDDepartment of Physiology Faculty of MedicineUniversity of ValenciaAv. Blasco Ibañez, 15 46010 Valencia (Spain)E-mail: [email protected]
Finally, the potential utility of alternative therapies, such as recombinant ACE2, Ang 1-7 peptides,
angiotensin II receptor inhibitors, and potentially aldosterone synthase inhibitors, for preventing or
mitigating ALI caused by viruses, is entirely unknown at the present time and requires consideration and
investigation for a disease for which current care is entirely supportive.
ACKNOWLEDGEMENTS
Fabian Sanchis-Gomar is supported by a postdoctoral contract granted by “Subprograma Atracció de Talent
- Contractes Postdoctorals de la Universitat de València.”
Potential Competing Interests: The authors have no association with commercial entities that could be
viewed as having an interest in the general area of the submitted manuscript.
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Figure legends
Figure 1. Localization of ACE2 protein in human organs and tissues.
Figure 2. Scheme of Renin-Angiotensin-Aldosterone system and SARS-CoV-2 infection mechanism.
Table 1. Professional societies recommendations following the statements on the issue. Recommended
continuing ARBs and ACEIs. Recommended continuing angiotensin receptor neprilysin inhibitors.
Adapted from NephJC.59 . Used with permission.
Date of publication Recommendation
European Society of Hypertension March 12, 2020 European Society of Cardiology Council on Hypertension March 13, 2020 Hypertension Canada March 13, 2020 Canadian Cardiovascular Society March 15, 2020
The Renal Association, United Kingdom March 15, 2020
International Society of Hypertension March 16, 2020American College of Physicians March 16, 2020Spanish Society of Hypertension March 16, 2020 American Heart Association March 17, 2020Heart Failure Society of America March 17, 2020 American College of Cardiology March 17, 2020 European Renal Association, European Dialysis and Transplant Association March 17, 2020
High Blood Pressure Research Council of Australia March 18, 2020