At this point it must be noted that an upregulation of ACE2 in heart cells by ACE inhibitors and angiotensin-1 receptor blockers could be shown in animal experiments with rats. There are also experiments on diabetic rats that show an influence of ibuprofen on the system. So far, however, there is no evidence that these drugs exacerbate the COVID-19 course. In the case of ACE inhibitors and sartans, the opposite could also be the case. There are also experimental data and hypotheses that ACE inhibitors and angiotensin1 receptor blockers can protect against the penetration of SARS-CoV-2. Neither of these contradictory hypotheses has so far been substantiated or refuted in clinical studies. Therefore, there is an urgent warning against simply stopping ACE inhibitor or sartan therapy.
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