Place of renin-angiotensin-aldosterone system inhibitors and statins in the treatment of cardiovascular patients in the context of COVID-19 pandemic

Abstract

Patients at high cardiovascular risk, older people with cardiovascular comorbidities, as well as those with hypertension and familial hypercholesterolemia are more susceptible to severe coronavirus disease 2019 (COVID-19). Such patients are likely to be at increased long-term atherothrombotic risk after COVID-19. The renin-angiotensinaldosterone system (RAAS) not only plays a key role in the development and progression of cardiovascular diseases, but is also responsible for the penetration of the Severe Acute Respiratory Syndrome CoronaVirus-2 (SARS-CoV-2) into the cells of target organs and the development of infection. Given that RAAS inhibitors and statins increase the expression of angiotensin-converting enzyme type 2 receptors, concerns were initially raised about their possible adverse effect on COVID-19 course. However, at present, we have data from large-scale, including randomized clinical trials and meta-analyses, confirming the organ protective effects of RAAS inhibitors and statins by reducing the inflammation severity and fibrosis in tissues. The review attempted to assess the potential role of these drugs in the management of SARS-CoV-2-infected patients and their impact on the development of complications.

Keywords

• coronavirus disease 2019 (covid-19)
• systemic inflammation
• cardiovascular risk
• hypertension
• hypercholesterolemia
• statins
• raas inhibitors