Evaluation of the potential benefit of renin-angiotensin system inhibitors (RASi, ACEi/ARB) in high-risk patients with COVID-19 : the COVID-RASi trial
The COVID-19 pandemic has impacted the health and economy of countries around the world, bringing a major challenge for physicians and healthcare systems, due to the lack of evidence-based therapy. Patients admitted with COVID had a higher risk for worsening conditions requiring ICU, ventilation, or dialysis, and high mortality. At the peak of the pandemic, many patients with COVID-19 infections were older, with pre-existing cardiovascular (CV) conditions (e.g., prior heart attack, stroke, peripheral arterial disease), or had risk factors such as hypertension, obesity, diabetes, or chronic kidney disease. The scientific and clinical implications showed these patients had higher mortality, confirming the major interactions with the cardiovascular system. While the role of renin-angiotensin system inhibitors (RASi) was known to be protective of the cardiovascular system, and the evidence also showed that the SARS-CoV-2 virus uses the Angiotensin-Converting Enzyme 2 (ACE2) receptors, more research was needed to find evidence-based answers to show if RASi medications are protective for patients with COVID-19.
Author(s): Liu, Peter