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ACEi/ARB use in patients with COVID-19


There is evidence that the renin-angiotensin system is important in coronavirus infection and observational data suggesting worse outcomes in patients with hypertension and COVID-19. This has led to speculation that ACEi/ARB use is harmful in patients with COVID-19. However, the basic science is far more complicated and there are conflicting data. There is a no clinical evidence indicating direct harm of ACEi/ARB use in COVID-19 infection.


Due to the significant morbidity and mortality benefit of ACEi/ARB in many cardiovascular diseases, such as heart failure, there are widespread recommendations by national and international societies NOT to routinely stop ACEi/ARB in patients with COVID-19 infection.


These societies include;

The British Cardiovascular Society and The British Society for Heart Failure (

The Renal Association (

The European Society of Cardiology (

The European Society of Hypertension (



Therefore, considering the pan-European and cross-specialty advice, patients in Cornwall who require ACEi/ARB therapy should NOT be routinely denied treatment due to COVID-19. This is particularly important given the significant benefits of ACEi/ARB therapy in cardiovascular disease and significant risks of worse outcomes with inappropriate drug withdrawal.



Dr Parminder Chaggar

RCH Consultant Cardiologist and Clinical Lead for Heart Failure

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