ОСОБЕННОСТИ ПРИМЕНЕНИЯ ЛЕКАРСТВЕННЫХ ПРЕПАРАТОВ, ВЛИЯЮЩИХ НА РЕНИНАН-ГИОТЕНЗИНОВУЮ СИСТЕМУ, У БОЛЬНЫХ С COVID-19

Abstract

Currently, the main task of public health authorities is a developing of coordinated global measures to prepare health systems to deal with the spread of coronavirus infection, an accompanying concern has been identified that is of particular interest to clinicians and researchers about hypertension. Hypertension, coronary artery disease and diabetes mellitus, especially in the elderly, increase susceptibility to SARS-CoV-2 infection. Antihypertensive drugs decrease blood pressure due to dilating blood vessels and decreasing cardiac output. One of the groups of these drugs includes inhibitors of angiotensin-converting enzymes (ACE). Angiotensin-converting enzyme 2 is a specific target for SARS-CoV-2, specially for the S-protein, which is located on its surface, and therefore the relationship of ACE inhibi- tors and the course of the disease plays an important role in treatment, since the penetration process and infection is facilitated by the affinity of the virus S-protein and the human ACE2 receptor. For this reason, the penetration of the virus into the host cells can be facilitated. However, this relationship does not affect the worsening of symptoms and the course of coronavirus infection due to the fact that when the SARS-CoV-2 spike protein (S-protein) binds to ACE2, it is possible to induce the induction of ACE2 shedding from the surface, which also reduces the surface expression of ACE2. The effect of the virus is not only due to binding to ACE2, but also to TMPRSS2. It has been proven that it is be- cause of its binding to TMPRSS2 that it plays a greater role in infection with SARS-CoV-2 than angiotensin-converting enzyme 2. Therefore, it is not advisable to stop taking antihypertensive drugs during coronavirus infection in people with cardiovascular diseases.