Renin-angiotensin-aldosterone inhibitors and COVID-19 infection

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Purpose of Review: This review summarises the literature data and provides an overview of the role and impact of the use of renin–angiotensin–aldosterone system (RAAS) inhibitors in patients with coronavirus disease 2019 (COVID-19) infection.

Recent Findings: The angiotensin-converting enzyme 2 (ACE2) has a key role in the regulation of the RAAS pathway, downregulating angiotensin II and attenuating inflammation, vasoconstriction and oxidative stress. Additionally, it plays an instrumental part in COVID-19 infection as it facilitates the cell entry of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and enables its replication. The use and role of RAAS inhibitors therefore during the COVID-19 pandemic have been intensively investigated.

Summary: Although it was initially assumed that RAAS inhibitors may relate to worse clinical outcomes and severe disease, data from large studies and meta-analyses demonstrated that they do not have an adverse impact on clinical outcomes or prognosis. On the contrary, some experimental and retrospective observational cohort studies showed a potential protective mechanism, although this effect remains to be seen in large clinical trials.
Original languageEnglish
Pages (from-to)425–433
Number of pages9
JournalCurrent Hypertension Reports
Early online date18 Jun 2022
Publication statusPublished - Oct 2022


  • Angiotensin-converting enzyme 2 (ACE2)
  • Coronavirus disease 2019 (COVID-19)
  • Renin–angiotensin–aldosterone system (RAAS)
  • Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)

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