Fármacos bloqueantes del SRAA y enfermedad por el SARS-CoV-2
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2021-12-02
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Jaén: Universidad de Jaén
Resumen
[ES] La actual pandemia de COVID-19 causada por el coronavirus del Síndrome Respiratorio Agudo
SARS-CoV-2) ha suscitado un interés especial por el Sistema Renina Angiotensina Aldosterona (RAAS), el
principal sistema hormonal implicado en la regulación de la presión arterial sanguínea. El SARS-CoV-2
utiliza como receptor para unirse y entrar a las células al ACE2, uno de los enzimas de la cascada del
RAAS. Los pacientes hipertensos son más propensos al desarrollo de síntomas severos de la COVID19,
por lo tanto, se ha debatido si el uso de fármacos inhibidores del RAAS, en particular los iACE y ARAII,
podrían empeorar el desarrollo de la enfermedad. En esta revisión bibliográfica se muestran los
aspectos más relevantes de la relación entre el SARS-CoV-2 y el RAAS, y se discute el impacto clínico del
uso de los iACE/ARAII sobre la COVID19. Finalmente, con los datos disponibles hasta el momento, se
concluye que no existe evidencia de que los iACE/ARAII empeoren la infección por el SARS-CoV-2,
incluso en algunas situaciones su uso podría ser beneficioso.
[EN] The current COVID-19 pandemic caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has generated special interest in the renin-angiotensin-aldosterone system (RAAS), the main hormonal system involved in blood pressure regulation. SARS-CoV-2 uses as a receptor to bind and infect cells, ACE2, one of the enzymes of the RAAS cascade. Hypertensive people are more likely to develop severe symptoms for COVID-19, therefore it has been debated if the use of RAAS-inhibiting drugs, which are used in the treatment of arterial hypertension, in particular, ACEi and ARA II, can make the disease worse. In this bibliographic review, the most important aspects of the relationship between SARS-CoV-2 and RAAS are shown, and the clinical impact of treatment with ACEi/ARA II on COVID-19 is reviewed. It is concluded that there are no clinical data showing that ACEi or ARA II increase the likelihood of contracting COVID-19 or worsen the outcome of SARS-CoV-2 infection, even in some cases they may be beneficial.
[EN] The current COVID-19 pandemic caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has generated special interest in the renin-angiotensin-aldosterone system (RAAS), the main hormonal system involved in blood pressure regulation. SARS-CoV-2 uses as a receptor to bind and infect cells, ACE2, one of the enzymes of the RAAS cascade. Hypertensive people are more likely to develop severe symptoms for COVID-19, therefore it has been debated if the use of RAAS-inhibiting drugs, which are used in the treatment of arterial hypertension, in particular, ACEi and ARA II, can make the disease worse. In this bibliographic review, the most important aspects of the relationship between SARS-CoV-2 and RAAS are shown, and the clinical impact of treatment with ACEi/ARA II on COVID-19 is reviewed. It is concluded that there are no clinical data showing that ACEi or ARA II increase the likelihood of contracting COVID-19 or worsen the outcome of SARS-CoV-2 infection, even in some cases they may be beneficial.