Author + information
- Received April 13, 2020
- Accepted April 13, 2020
- Published online May 25, 2020.
- aDepartment of Medicine, Division of Cardiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
- bDepartment of Medicine, Division of Cardiology, Center for Cardiovascular Research, Washington University School of Medicine, St. Louis, Missouri
- ↵∗Address for correspondence:
Dr. Bonnie Ky, University of Pennsylvania School of Medicine, Smilow Center for Translational Research, 3400 Civic Center Boulevard, 11-105, Philadelphia, Pennsylvania 19104.
- ↵∗∗Dr. Douglas L. Mann, Center for Cardiovascular Research, Washington University School of Medicine, 660 S. Euclid Avenue, Campus PO Box 8086, St. Louis, Missouri 63110.
• SARS-CoV-2, the virus that causes COVID-19, is a novel CoV that infects humans by binding to ACE2, which degrades angiotensin II, and hence plays a critical role in modulating the renin angiotensin system (RAS).
• The emerging epidemiology of COVID-19 suggests that patients with cardiovascular risk factors, including older age, cardiovascular disease, or cancer may be more susceptible to infection and suffer from worse clinical outcomes.
• Because of the limited understanding with respect to the interaction of RAS inhibitors and SARS-CoV-2 infectivity, we endorse current society recommendations to continue RAS antagonists for clinical indications for which these agents are known to be beneficial.
• Treatments for COVID-19 that are undergoing clinical trials range from therapies that block the entry of SARS-CoV-2 into host cells, to repurposed antiviral therapies such as protease inhibitors and nucleoside analogs that block viral replication by inhibiting viral RNA-dependent RNA polymerase.
The coronavirus disease-2019 (COVID-19) pandemic has resulted in a proliferation of clinical trials designed to slow the spread of severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2). Many therapeutic agents that are being used to treat patients with COVID-19 are repurposed treatments for influenza, Ebola, or for malaria that were developed decades ago and are unlikely to be familiar to the cardiovascular and cardio-oncology communities. Here, the authors provide a foundation for cardiovascular and cardio-oncology physicians on the front line providing care to patients with COVID-19, so that they may better understand the emerging cardiovascular epidemiology and the biological rationale for the clinical trials that are ongoing for the treatment of patients with COVID-19.
This work was supported by grants from the National Institutes of Health (R21HL141802, R34HL146927, and R01HL118018 to Dr. Ky; and R01HL107594 and U10 HL110309 to Dr. Mann) and the American Heart Association (TPA34910059 to Dr. Ky). This paper will co-publish in JACC: Basic to Translational Science and JACC: CardioOncology.
The authors attest they are in compliance with human studies committees and animal welfare regulations of the authors’ institutions and Food and Drug Administration guidelines, including patient consent where appropriate. For more information, visit the JACC: Basic to Translational Science author instructions page.
- Received April 13, 2020.
- Accepted April 13, 2020.
- 2020 The Authors