Inhibitors of Angiotensin-converting Enzyme or Blockers of Angiotensin-2 Receptor in COVID-19 Patients with Comorbid Cardiovascular or Pulmonary Diseases

  Following the skyrocketing spread of SARS-CoV-2 into almost all the countries over five continents, diverse clinical strategies are urgently needed to defeat its pandemic, considering that an magic-bullet antiviral vaccine or treatment is presently unavailable. WHO later proclaimed the viral outbreak as a pandemic. Despite this fast speed of the pandemic, any recommended treatment must first pass initial clinical and para-clinical testing. Antiviral therapy, immunotherapy, and application of prophylactic vaccines are recommended in the management of this pandemic, but no definitive intervention has been validated to treat the COVID-19 patients. Whether SARS-CoV-2 infection can directly affect the cardiovascular system is unknown. Furthermore, other pathogenic mechanisms underlying this viral infection are largely unclear. Thus, it is risky to administer any intervention in emergency treatment of the vulnerable patients with comorbid CVDs. Conclusively, while we lack evidence-based facts to confirm a significant association between the poor prognosis of COVID-19 patients and high expression of angiotensin-converting enzyme 2, administering any new treatment in CVD patients should be done prudently.