I checked the 3 main citations in that article based on this statement:Another interesting fact, the vast majority of those who are dying from COVID also happen to be taking ACE inhibitors such as Lisinopril, Losartan, etc.
https://www.infectioncontroltoday.c...-link-ace-inhibitors-severe-covid-19-symptoms
My annotation of those references:Other researchers have observed that lisinopril and losartan can increase (or upregulate) the ACE2 Receptor mRNA cellular expression by five and three-fold, respectively.4 This has given rise to concerns that these inhibitors may increase ACE2 Receptor cellular surface expression leading to exacerbated viral load in cells.
continues...
There is mounting consensus that ACE inhibitors may be a primary driver of the severe symptoms. The concerns have been raised in the Lancet8 and most recently in Medscape.9
(4) Re: Preventing a covid-19 pandemic: ACE inhibitors as a potential risk factor for fatal Covid-19. BMJ. Feb. 28, 2020. Vol. 368. https://www.bmj.com/content/368/bmj.m810/rr-2
This is a review article with no new data. It discusses the hypothetical pros and cons of using ACE2 inhibitors that up regulate ACE2 binding sites.
(8) Fang L, Karakiulakis G, Roth M. Are patients with hypertension and diabetes mellitus at increased risk for COVID-19 infection? The Lancet Respiratory Medicine. March 11, 2020. https://www.thelancet.com/journals/lanres/article/PIIS2213-2600(20)30116-8/fulltext
"If this hypothesis were to be confirmed, it could lead to a conflict regarding treatment because ACE2 reduces inflammation and has been suggested as a potential new therapy for inflammatory lung diseases, cancer, diabetes, and hypertension."
I could not find an article by L. Fang et al. with data showing ACE2 inhibitors were a separate risk factor. That is, it is all hypothesis. None use multivariate analysis to parse out the risk of using ACE2 inhibitor medications per se.
(9) Hughes S. COVID-19 and Angiotensin Drugs: Help or Harm?. Medscape. March 25, 2020. https://www.medscape.com/viewarticle/927542
This is another review article that seems reasonable balanced. The conclusion is that the role of ACE2 inhibitors has not been resolved, Maybe they help; maybe they hurt.


