What you need to know about ACE inhibitors and a higher risk for severe COVID-19

You’ve probably heard that people with chronic health conditions are more at risk for developing a severe case of COVID-19. That includes people with high blood pressure, heart disease, diabetes, kidney disease and a wide range of other issues.

The assumption here is that these chronic diseases impair your body’s ability to respond to the virus. Your heart may be weaker. Your lungs may be inflamed. Or your immune system may not be as strong. And all these factors leave you more vulnerable to damage from the virus.

But your chronic disease’s impact on your body may not be the only factor influencing your risk for severe COVID-19. The medication you’re taking to treat your disease could be behind your likelihood of developing a more serious case as well.

Obviously, any medication that suppresses your immune system is going to put you at a higher risk, and those medications are incredibly common among people with autoimmune disorders.

But a recent scientific analysis suggests that two other common medications may be putting people at risk for a more severe case of COVID-19 — ACE inhibitors and angiotensin receptor blockers.

Medications that may give the novel coronavirus an easy path into your lungs

ACE inhibitors and angiotensin receptor blockers are medications that are commonly taken by people with heart disease, high blood pressure, diabetes, and chronic kidney disease. In fact, many people (mostly older adults) take them every day.

But a new scientific paper from a researcher at Louisiana State University shows that these medications may contribute to the severe lung complications that arise in some people with COVID-19.

The paper was written by James Diaz, Professor and Head of Environmental Health Sciences at LSU Health New Orleans School of Public Health. According to Diaz, SARS-CoV-2 (the virus that causes COVID-19) binds to angiotensin-converting enzyme 2 (ACE2) receptors in the lower respiratory tract to get into the lungs.

Previous research shows that people who receive intravenous infusions of ACE inhibitors develop more ACE2 receptors. That means they have more potential points where the virus can enter their lungs. People treated with angiotensin receptor blockers (ARBs) also develop increased numbers of ACE2 receptors in their lungs. Diaz theorizes that by giving the virus more entry points, these medications may be making people incredibly vulnerable to the virus.

A recent Chinese study supports Diaz’s theory. The study found that people with hypertension, coronary artery disease, diabetes, and chronic renal disease — all conditions that would be treated with ACE inhibitors and angiotensin receptor blockers — had more severe cases of COVID-19. The study didn’t confirm that patients were taking these drugs for sure. But all the patients with these conditions met the standards for being treated with these drugs.

Don’t stop taking medications yet

Diaz has a strong theory developed so far. But there still needs to be controlled studies in people with COVID-19 infections who confirm that they’re taking ACEIs or ARBs before we’ll know for sure whether he’s right.

In the meantime, don’t stop taking any medications you’re currently taking without talking to your doctor. And of course, keep doing all the things you’re already doing to reduce your risk of COVID-19 — social distancing, washing your hands, not touching your face, wearing a mask in public. And of course, stay strong and positive.

Sources:

1. Why COVID-19 infections affect people differently — Quartz
2. ACE inhibitors and angiotensin receptor blockers may increase the risk of severe COVID-19 — MedicalXpress
3. Hypothesis: angiotensin-converting enzyme inhibitors and angiotensin receptor blockers may increase the risk of severe COVID-19 — Journal of Travel Medicine