Far from renin-angiotensin system blockers putting patients at greater danger from COVID-19, recent research now suggests the drugs might even confer some benefit.

The knowledge that the SARS-CoV-2 virus uses its infamous ‘spike protein’ to enter cells via their ACE2 receptors has led to concern that patients on ACE inhibitors or ARBs might be more susceptible to infection.

Renin-angiotensin system (RAS) blockade increases ACE2 receptor expression in mice, and there is some evidence supporting this in humans too, according to a commentary in JAMA Cardiology.

But there is also evidence that serum angiotensin II levels in patients with COVID-19 pneumonia are significantly higher compared with healthy individuals and are linearly associated with viral load and lung injury, write the authors, led by hypertension expert Professor Franz Messerli of the University of Bern, Switzerland.