Taking Renin-Angiotensin Drugs in Patients with COVID-19: Start, Continue, or Stop; a Literature Review

  Considering the pandemic of the COVID-19 disease, the use of various drugs in patients has been investigated. Recently, numerous studies have been done on the effectiveness of drugs which used to treat the underlying disease such as congestive heart failure, hypertension, as well as coronary artery disease in various countries, because the patients with underlying conditions are more likely to develop COVID-19 disease. Two classes of the most commonly used drugs in these underlying diseases are angiotensin converting enzyme inhibitor and angiotensin-receptor-blocking drugs. Because the two classes of drugs that mentioned above increase the levels of enzyme-converting enzyme receptor-2, it has been hypothesized that the initiation or continuation of such drugs will play some roles in initiation, progression or acceleration of the COVID-19 disease. In the case of a COVID-19 pandemic, there are some questions; which method should be chosen? start, continue or stop of the two classes of drugs as well as which one should be chosen to have a lower risk in patients suffering from COVID-19?. Accordingly, the studies reported from different countries which conducted with the aim of investigating this assumption, was reviewed in this article. As a result, all of those studies have announced this common result that the start-up order for these two groups of drugs in patients with COVID-19, who have underlying cardiovascular disease, should be treated in the same way as other patients, based on valid and accepted current guidelines. Furthermore, do not discontinue these medications if the patient has taken any of them before having COVID-19 disease.