Clinical effects of angiotensin-converting-enzyme inhibitors on lung computed tomography findings in patients with COVID-19 pneumonia: Is it useful?

Aim: Angiotensin-converting enzyme 2 (ACE2) has a significant physiological role in the renin – angiotensin – aldosterone system (RAAS) pathway. The ACE2 receptor acts as a virus receptor in the pathogenesis of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) disease. In this study, we aimed to investigate the effects of ACEIs use on radiological imaging and clinical course in COVID-19. Methods: In this study, patients who had been using medications for the diagnosis of hypertension and who were hospitalized in Haydarpasa Numune Training and Research Hospital due to COVID-19 pneumonia were retrospectively evaluated. Results: The mean age of 107 patients included in this study was 68,49±11,95, and 50.5% (n = 54) of them were male. The patients were divided into two separate study groups as ACEIs users and non-users. In the first of these groups, 55 patients were using ACEIs due to hypertension. In the second group, 52 patients were using calcium channel blockers (CCBs), β-blockers, alpha-2 blockers, or diuretics, alone or in combination. When the lung computed tomography images were examined, multilobar findings were less common in the ACEIs group, which was remarkable (p <0.001). When the clinical endpoint was evaluated, the findings showed that the mortality rates were different in the groups ACEIs users and non-users (12.7% vs. 32.7%, respectively, p=0.013). Conclusion: Although the role of RAAS blockade in COVID-19 is still not fully elucidated, we have shown that COVID-19 progresses with less damage in the lungs with patients who have been using ACEIs.