What solid organ transplant healthcare providers should know about renin-angiotensin-aldosterone system inhibitors and COVID-19 |
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| Authors: | Sunnie Y Wong Aleah L Brubaker Aileen X Wang Adetokunbo A Taiwo Marc L Melcher |
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| Institution: | 1. Division of Abdominal Transplantation, Dept. of Surgery, Stanford University, Stanford, CA, USA;2. Division of Nephrology, Dept. of Medicine, Stanford University, Stanford, CA, USA |
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| Abstract: | The data on the outcomes of solid organ transplant recipients who have contracted coronavirus disease 2019 (COVID-19) are still emerging. Kidney transplant recipients are commonly prescribed renin-angiotensin-aldosterone system (AAS) inhibitors given the prevalence of hypertension, diabetes, and cardiovascular disease. As the angiotensin-converting enzyme 2 (ACE2) facilitates the entry of coronaviruses into target cells, there have been hypotheses that preexisting use of renin-angiotensin-aldosterone system (RAAS) inhibitors may increase the risk of developing severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. Given the common use of RAAS inhibitors among solid organ transplant recipients, we sought to review the RAAS cascade, the mechanism of SARS-CoV-2 entry, and pertinent data related to the effect of RAAS inhibitors on ACE2 to guide management of solid organ transplant recipients during the COVID-19 pandemic. At present, there is no clear evidence to support the discontinuation of RAAS inhibitors in solid organ transplant recipients during the COVID-19 pandemic. |
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| Keywords: | ACE2 receptor COVID-19 renin-angiotensin-aldosterone inhibitors solid organ transplant |
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