key: cord-0908343-k5kkd5qp
authors: Yoganathan, Anusha; Sajjad, Menahel S.; Harky, Amer
title: Cardiovascular disease and the impact of COVID‐19
date: 2020-06-16
journal: J Card Surg
DOI: 10.1111/jocs.14682
sha: 6955c12361ab6c423d1362f4881a48f98163ca0a
doc_id: 908343
cord_uid: k5kkd5qp

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It is, by now, well established that patients with pre-existing cardiovascular diseases, such as hypertension or ischemic heart disease, are more vulnerable and at risk from severe complications due to COVID-19. One of the most important pathophysiology of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is lying in its affinity to renin-angiotensin-aldosterone system (RAAS) through angiotensin converting enzyme inhibitor (ACEi) or utilization of angiotensin receptor blockers (ARBs). Several studies have reported equivocal outcomes in using ACEi and ARBs in patients with COVID-19, whether they were using ACEi/ARBs before contracting COVID-19 or they were initiated/suspended during the course of the infection; yet there is lack of robust evidence supporting the use or discontinuation of RAAS medications. 2, 3 Although, there is a theory that ACEi/ARBs antagonise RAAS which might reduce inflammation in COVID-19 pneumonia, thus reducing mortality. 2, 4 The study by Zhang et al 4 

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