Date of Award
2026
Document Type
Capstone
Degree Name
Master of Science (MS)
Department
Physician Assistant Studies
Committee Chair
LaDonna Clark
Abstract
Introduction: Coronavirus disease 2019 (COVID-19) is a contagious disease caused by the virus SARS-CoV-2 and can cause debilitating illness in vulnerable patient populations. The purpose of this clinical review is to analyze the effects of angiotensin-converting enzyme inhibitors and angiotensin receptor blockers on the clinical course and severity in COVID-19 adult patients.
Methods: PubMed was searched with a specific search strategy using key terms “adult,” “COVID-19,” and “RAAS inhibiting medications.” Specific operators and filters narrowed the results to a total of five relevant, quality articles for review.
Results: Two articles were randomized controlled trials that directly compared the continuation of ACEI or ARB use to the discontinuation of ACEI or ARB use in COVID-19 patients. One article was a randomized controlled trial that directly compared the initiation of ACEI or ARB therapy versus no initiation of ACEI or ARB therapy in COVID-19 patients. Two articles were meta-analyses that discussed findings of RAS inhibition in patients with COVID-19. Results overall support no significant effects of ACEI or ARB drug therapy on COVID-19 severity or outcomes.
Discussion: The articles reviewed generated largely neutral results, in that both the continuation or discontinuation of RAS inhibition do not appear to significantly affect the course or severity of COVID-19. Some results were mixed, in that some did suggest that outcomes could be improved with RAS inhibition use, while others suggested outcomes would be worsened. Additional research including longer term follow-up and high-quality studies is needed, but the evidence of this review largely does not support standard discontinuation or initiation of ACEIs or ARBs in patients with COVID-19.
Recommended Citation
Edwards ML. Effects of Angiotensin-Converting Enzyme Inhibitors and Angiotensin Receptor Blockers on COVID-19 Outcomes in Severely Ill Patients. The PA Department Journal of Medical Science. 2025. https://digitalcommons.gardner-webb.edu/pa-department-journal-of-medical-science/50
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