There has been some suggestion on the internet and elsewhere that Angiotensin Converting Enzyme Inhibitors (ACEI) and Angiotensin Receptor Blockers (ARB) may increase morbidity and mortality associated with COVID-19. This theory derived from the observation that these medications upregulate the ACE2 Receptor, which is the possible portal of entry of COVID-19 into lung tissue. Coronaviruses have been observed entering the human host through the ACE2 pathway.
Although the observed and speculated physiology seems interesting, particularly with the relatively newly discovered and understood ACE 2, the American College of Carfiology, the American Heart Association, the Heart Failure Society of America, and the European Society of Cardiology agree that there is no sound scientific basis to suggest ACEI/ARB may be unsafe in this era of COVID-19.
Because ACEI/ARB have such superior data demonstrating favorable outcomes for heart failure, cardiovascular eevents, and proteinuria, I would urge my patients not to stop or exchange these antihypertensive/heart failure medications.