Latest data support continued use of ACE inhibitors and ARB medicines during COVID-19 pandemic
Recent observational studies of angiotensin converting enzyme (ACE) inhibitors and angiotensin
receptor blockers (ARBs, also called sartans) have not shown an effect of these medicines on the risk
of becoming infected with severe acute respiratory syndrome coronavirus 2 (the virus causing COVID19) and do not indicate a negative impact on the outcome for patients with COVID-19 disease.
EMA therefore reiterates its previous advice that patients should continue to use ACE inhibitors or ARBs
as advised by their doctors. Patients with questions or concerns about their treatment should consult a
healthcare professional.
ACE inhibitors and ARBs are used for treating patients with high blood pressure, heart problems or
kidney disease. In April 2020, media outlets and publications raised concerns about the effects of these
medicines in patients with COVID-19. As part of the ongoing monitoring of the safety of medicines, 20
recently published studies on the use of ACE inhibitors and ARBs during the COVID-19 pandemic were
reviewed and showed that these concerns are not supported by the latest clinical evidence.
EMA and the EU regulatory network will continue monitoring available and emerging data on the use of
medicines during the ongoing COVID-19 pandemic and are working with other regulators and relevant
European and international organisations to provide reliable advice on the safe use of medicines.
Further information on recommendations about COVID-19 is available on EMA?s website and the
websites of national competent authorities.
This public health statement has been issued by the COVID-19 EMA pandemic Task Force (COVIDETF).
References
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SARS-Covid-19 infection in a multi-site UK acute Hospital Trust. doi:
10.13140/RG.2.2.34883.14889/1.
2. de Abajo F, Rodr?guez-Mart?n S, Lerma V et al. Use of renin?angiotensin?aldosterone system
inhibitors and risk of COVID-19 requiring admission to hospital: a case-population study. doi:
10.1016/S0140-6736(20)31030-8.
3. Felice C, Nardin C, Di Tanna GL et al. Use of RAAS inhibitors and risk of clinical deterioration in
COVID-19: results from an Italian cohort of 133 hypertensives. doi: 10.1093/ajh/hpaa096.
Latest data support continued use of ACE inhibitors and ARB medicines during COVID19 pandemic
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system and risk of SARS-CoV-2 infection. doi: 10.1093/cid/ciaa634.
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inhibitors with COVID-19-related outcomes in Korea: a nationwide population-based cohort
study. doi: 10.1093/cid/ciaa624/5842160.
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Covid-19. doi: 10.1056/NEJMoa2007621. The publication of this study was subsequently
retracted by the authors. doi: 10.1056/NEJMc2021225. The retraction has no impact on this
public statement as the study did not influence the conclusions.
11. Mehta N, Kalra A, Nowacki AS et al. Association of Use of Angiotensin-Converting Enzyme
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Latest data support continued use of