A Meta-analysis of the Relationship Between Renin-Angiotensin-Aldosterone System Inhibitors and COVID-19
Abstract
The angiotensin converting enzyme (ACE) 2 is a cell surface protein used for entry into type II pneumocytes and other tissues by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) – the infective agent of COVID-19. It has been demonstrated that ACE2 is upregulated on tissues by renin-angiotensin-aldosterone system (RAAS) inhibitors. This raised concerns that RAAS inhibitors may increase susceptibility and worsen prognosis in COVID-19. In contrast, ACE2 facilitates degradation of angiotensin II and has an anti-inflammatory function and may actually protect the lungs and other tissues from injury. Thus, the effect of RAAS inhibitors on susceptibility and prognosis of COVID-19 continues to be the subject of much debate. Individual observational studies in the area have yielded equivocal results; hence, we sought to conduct a meta-analysis of all available data to provide greater insight...