Blocking angiotensin earlier with RAS blockers, statins, and heparin in high-risk COVID-19 patients: Is the remedy here?

Early data about the coronavirus disease 2019 (COVID-19) showed that older male patients with hypertension and diabetes mellitus were more likely to die of COVID-19 (1). This was linked to the fact that the virus uses angiotensin-converting enzyme 2 (ACE2) as a receptor. Some medical experts question the safety of using angiotensin-converting enzyme inhibitors (ACEI) and angiotensin receptor blockers (ARBs) among COVID-19 patients because ACE2 levels are increased in patients who are on ACEI/ ARBs treatment (2). However, some recently published papers hypothesized that ACEI and ARBs might be even beneficial in COVID-19 patients, since ACE2 decreases the level of angiotensin 2 (AT2) (3, 4). We also hypothesized that the catastrophic clinical picture in susceptible patients could be as a result of increased AT2 levels. In this paper, we discussed whether early use of well-known drugs that have some inhibitory effects on AT2 such as ACEI/ARB, statins, and heparin could reverse AT2 effects on the body.