CONCLUSION
The anti-inflammatory role of ACEI/ARB offers a very attractive
treatment option in hypertensive or heart failure patients at risk or
suffering from COVID-19. However it would not be prudent to rationalize
clinical usage solely based on mechanistic hypothesis without gathering
robust evidence from comprehensive clinical trials. Currently, none of
the practice guidelines in cardiology around the globe favors ad-hoc
discontinuation of ACEI/ARB in a patient at risk of COVID. On the other
hand there is also no compelling data, currently, to recommend
introduction of ACEI/ARB into the therapy regimen of COVID-19 patient.
However, taking view of the available evidence of favorable
immuno-mechanistic and clinical outcome data, continuation of ACEI/ARB
in patients of hypertension and heart failure seems to be a more prudent
approach, even though they are at risk of or suffering from COVID-19.
ACKNOWLEDGEMENT : DS wants to thank DST-INSPIRE for the
fellowship
CONFLICT OF INTEREST : Authors declare no conflict of interest