The Medicines and Healthcare products Regulatory Agency (MHRA) has responded to claims that angiotensin converting enzyme (ACE) inhibitors or angiotensin receptor blockers (ARBs) might worsen COVID-19 infection.
The MHRA says there is no evidence from clinical or epidemiological studies to support the claim and says patients receiving ACE-inhibitors or ARBs for hypertension should be advised to continue the treatment.
The statement follows widespread media coverage of the findings of a study published in The Lancet Respiratory Medicine which suggests patients with cardiac diseases, hypertension or diabetes who are treated with ACE-2-increasing drugs are at higher risk for severe COVID-19 infection.
The finding is a hypothesis based on an analysis of data from studies on the most frequent underlying comorbidities in patients with COVID-19. The first study found that among 32 intensive care patients who died, the most common comorbidities were cerebrovascular diseases (22%) and diabetes (22%).
The second study included 1099 patients with confirmed COVID-19, of whom 173 had severe disease. Common comorbidities were hypertension (23.7%), diabetes (16.2%), coronary heart diseases (5.8%) and cerebrovascular disease (2.3%).
In the third study of 140 patients who were admitted to hospital with COVID-19, 30 per cent had hypertension and 12 per cent had diabetes.
The authors of the analysis theorised that because the most common comorbidities in patients with severe COVID-19 infection are often treated with drugs that target ACE and because molecular studies of SARS and COVID-19 have shown an affinity for ACE receptors, these therapies could lead to more severe disease.
The MHRA says it is working closely with the Commission on Human Medicines and other regulatory bodies to examine any new data that may emerge.