Zhonghua Jie He He Hu Xi Za Zhi. 2020 Feb 16;43(0):E014. doi: 10.3760/cma.j.issn.1001-0939.2020.0014. [Epub ahead of print]
[Inhibitors of RAAS Might Be a Good Choice for the Therapy of COVID-19 Pneumonia].

[Article in Chinese; Abstract available in Chinese from the publisher]

Sun ML1, Yang JM2, Sun YP1, Su GH3.

in English, Chinese

The novel coronavirus 2019 (COVID-19) infected patients by binding human ACE2, leading to severe pneumonia and highly mortality rate in patients. At present, there is no definite and effective treatment for COVID-19. ACE2 plays an important role in the RAAS, and the imbalance between ACE/Ang II/AT1R pathway and ACE2/Ang (1-7)/Mas receptor pathway in the RAAS system will lead to multi-system inflammation. Increased ACE and Ang II are poor prognostic factors for severe pneumonia. Animal studies have shown that RAAS inhibitors could effectively relieve symptoms of acute severe pneumonia and respiratory failure. The binding of COVID-19 and ACE2 resulted in the exhaustion of ACE2, and then ACE2/Ang (1-7)/Mas receptor pathway was inhibited. The balance of the RAS system was broken, and this would lead to the exacerbation of acute severe pneumonia. Therefore, we speculate that ACEI and AT1R inhibitors could be used in patients with COVID-19 pneumonia under the condition of controlling blood pressure, and might reduce the pulmonary inflammatory response and mortality.






I tell about ARB medicin (AT1R blocking  medicin)  Atacand:  When I had to begin medicin against  hypertension and  also tendence to  heart insufficience, I did use Atacand , because I did not tolerate ACEI or  beta-blockers then,  not even hydrochlorotiatzide.  So I did notice that Atacand  4 mg  had even ” diuretic”, anti-oedem   effect and I had  easier to breath,   it was  very good  feeling to the lungs and  breathing , too, not only against blood pressure. My PEF is not so  voluminous  , 310 ml  as best if I have no flu)

Then  – with time , samoe years ago Atacad  began  to be  too strong to take every day, ( hypotension making)  so nowadays I use  it against   acute hypertension only, and daily  Salures 5 mg only, but if it happens something  (  stressful  things)  that   the blood pressure  goes up too much to  170/95 or more , so  ambulatory I take 8 mg Atacand once a day ,  and during   some 1-2-3-  days  the blood pressure again  stabilizes so that   bendroflumetazid 5 mg is again   enough for me . For me Atacand is  a good  acute medicin  ( before I used it so long period that  pehrhaps my body  develoedp receptors for it and they are now ready).   I feel so that Atacand  is  lung- and kidney diuretics.  better perhaps  to say . anti- pulmonar oedem drug and   even diuretics some way.  Any how easier to breath.   But  of cause it is individual, but  i dont use more than 4 mg or 8 mg  per day when  I  have  troubles with acute blood pressure. (  Because I have  mild vitium cordis, so  I feel  pressure toward lungs, sometimes, too). So I am sure  Atacand can be beneficial  in ARDS  of   COVID-19 NCP, especially  when  both heart, kidney  and lung are compromized.  What is  a good   dose,  I can not say to others, but for me  4 mg- or 8 mg  is already  a real dose and it is cumulating during time.

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