The use of renin-angiotensin system blockers in patients with COVID-19

The COVID-19 pandemic poses a lot of questions for doctors regarding the treatment of both the coronavirus disease itself and the comorbidities. It is known that SARS-CoV-2 enters the cells through the angiotensin-converting enzyme (ACE)-2 receptor, which raises the question about permissibility of the use of renin-angiotensin system (RAS) blockers, and specifically ACE inhibitors, in these patients. Numerous cohort studies, single randomized controlled trials and their meta-analyzes have demonstrated the safety of the use of RAS blockers in COVID-19 patients, as well as their organoprotective effect. It remains unclear whether these drugs have their own beneficial effect on the course of COVID-19. The selection of a particular RAS blocker in patients with coronavirus infection and cardiovascular comorbidities should be based on the pharmacokinetic and pharmacodynamic features of the drugs, as well as the analysis of comorbidity and the assessment of possible drug interactions.