A team of researchers from Israel’s Sackler Faculty of Medicine has proposed that angiotensin receptor blockers (ARBs), including the drug losartan, might serve as a potential treatment for COVID-19. Their commentary, published on PubMed, was based on observations of how the SARS-CoV-2 virus enters human cells and how these medications work in the body. As of March 18, 2020, the virus had infected more than 180,000 people worldwide and caused over 7,000 deaths.
The Israeli scientists, working in the Department of Human Molecular Genetics and Biochemistry, noted that the angiotensin-converting enzyme 2 (ACE2) serves as the binding site for SARS-CoV-2, just as it did for the SARS virus that emerged in the early 2000s. “A tentative suggestion based on existing therapeutics, which would likely be resistant to new coronavirus mutations, is to use available angiotensin receptor 1 (AT1R) blockers, such as losartan, as therapeutics for reducing the aggressiveness and mortality from SARS-CoV-2 virus infections,” the researchers stated.
ARBs are a class of pharmaceuticals that influence the renin-angiotensin system. They work by relaxing veins and arteries to lower blood pressure and assist the heart in pumping blood more efficiently. Doctors also prescribe these drugs to prevent or treat chronic kidney disease, heart failure, and kidney failure in diabetic patients.
Peter Sever, a professor of clinical pharmacology and therapeutics at Imperial College London, expressed support for the concept. “These drugs could reduce the risk of serious lung disease following infection,” he said.
The Israeli team concluded that after successful animal safety tests, a series of studies and trials should be conducted to confirm the drugs’ effectiveness in treating humans.
Australian Researchers Raise Concerns
Other scientists have rejected this hypothesis. A paper published in The Lancet Respiratory Medicine argued that ARBs might actually increase the risk of severe COVID-19 by altering the shape of human cells. “We suggest that patients with cardiac diseases, hypertension, or diabetes, who are treated with ACE2-increasing drugs, are at higher risk for severe COVID-19 infection and, therefore, should be monitored for ACE2-modulating medications, such as ACE inhibitors or ARBs,” the paper stated.
This conflicting advice has caused confusion among patients. Individuals taking ARBs for high blood pressure, diabetes, and other conditions have questioned whether they should stop their medication due to fears about coronavirus infection.
Medical Experts Advise Against Stopping Medication
Medical professionals from Europe and Australia have recommended that patients continue using ACE inhibitors and ARBs for their existing conditions until more evidence becomes available. Hugh Montgomery, a professor of intensive care medicine at University College London, said: “There is no proof yet that the use of ACE inhibitors worsen coronavirus infection. There are theoretical reasons, in fact, why they might offer benefit in serious disease.
I would not advocate people ceasing such medication until the evidence has been weighed and clear guidance issued.” This cautious advice reflects the reality that stopping blood pressure medication can lead to serious health consequences. The potential risk from COVID-19 remains theoretical, while the benefits of these drugs for heart and kidney conditions are well documented.
Broader Search for Treatments Continues
The debate over ARBs is part of a larger global effort to find treatments for COVID-19. Scientists are testing existing drugs, developing new antivirals, and working on vaccines. The process is slow and uncertain, with many proposed treatments failing in clinical trials.
The Israeli team’s suggestion is one of many hypotheses being explored. It is based on an understanding of how the virus enters cells and how the body’s renin-angiotensin system responds to infection.
However, the conflicting views from other researchers highlight the difficulty of drawing conclusions from theoretical models alone. Clinical trials will be necessary to determine whether ARBs help or harm COVID-19 patients. Until then, the advice from medical authorities is clear: patients should not change their medication without consulting a doctor.
The situation illustrates the challenge of making public health recommendations during a fast-moving pandemic, as scientists work with incomplete data and their conclusions can shift as new evidence emerges.
