Citation Information :
Samajdar SS, Saha D, Sahoo S, Sen S. ACE Inhibitor-induced Dry Cough and Dysgeusia: COVID-19 Symptom Mimickers—A Case Series. Bengal Physician Journal 2021; 8 (2):49-51.
An outbreak of pneumonia caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) that started in China in the year 2019 has become a global pandemic. SARS-CoV-2 enters the host cell through the angiotensin-converting enzyme 2 (ACE2) receptor, which is known to be down-regulated in COVID-19 infected individuals. ACE inhibitors (ACEI) and angiotensin receptor blockers (ARB) can modulate and most probably up-regulate ACE2 expression and can be a therapeutic option, especially in COVID-19 patients with hypertension. ACEI itself can cause dry cough and loss of taste in some susceptible individuals, which can intimate the symptoms of COVID-19 infection itself and can put the treating physician into a diagnostic dilemma. Careful evaluation and discontinuation of the drug can reverse the symptoms dramatically.
WHO. Clinical management of severe acute respiratory infection when Novel coronavirus (nCoV) infection is suspected: interim guidance. Available at: https://www.who.int/publications-detail/clinical-management-of-severe-acute-respiratory-infection-whennovel-coronavirus-(ncov)-infection-is-suspected (accessed 11 January 2020)
Garg S, Kim L, Whitaker M, et al. Hospitalization rates and characteristics of patients hospitalized with laboratory-confirmed coronavirus disease 2019 - COVID-NET, 14 states, March 1–30, 2020. MMWR Morb Mortal Wkly Rep 2020;69:458–464. DOI: 10.15585/mmwr.mm6932e3.
Zhang P, Zhu L, Cai J, et al. Association of inpatient use of angiotensin-converting enzyme inhibitors and angiotensin II receptor blockers with mortality among patients with hypertension hospitalized with COVID-19. Circ Res 2020;126:1671–1681. DOI: 10.1161/CIRCRESAHA.120.317134.
Gheblawi M, Wang K, Viveiros A, et al. Angiotensin-converting enzyme 2: SARS-CoV-2 receptor and regulator of the renin-angiotensin system: celebrating the 20th anniversary of the discovery of ACE2. Circ Res 2020;126(10):1456–1474. DOI: 10.1161/CIRCRESAHA.120.317015.
Chobanian AV, Bakris GL, Black HR, et al. The seventh report of the joint national committee on prevention, detection, evaluation, and treatment of high blood pressure: the JNC 7 report. JAMA 2003;289:2560–2572. DOI: 10.1001/jama.289.19.2560.
Morimoto T, Gandhi TK, Fiskio JM, et al. An evaluation of risk factors for adverse drug events associated with angiotensin-converting enzyme inhibitors. J Eval Clin Pract 2004;10:499–509. DOI: 10.1111/j.1365-2753.2003.00484.x.
WHO. Q&A on coronaviruses (COVID19). 2020. Available at: https://www.who.int/emergencies/diseases/novelcoronavirus-2019/question-and-answers-hub/q-a-detail/qa-coronaviruses (accessed 17 November 2020)
Huang C, Wang Y, Li X, et al. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet 2020;395:497–506. DOI: 10.1016/S0140-6736(20)30183-5.
Chen N, Zhou M, Dong X, et al. Epidemiological and clinical characteristics of 99 cases of 2019 novel coronavirus pneumonia in Wuhan, China: a descriptive study. N Engl J Med 2020;395:507–513. DOI: 10.1016/S0140-6736(20)30211-7.
Zhou P, Yang X-L, Wang X-G, et al. A pneumonia outbreak associated with a new coronavirus of probable bat origin. Nature 2020;579:270–273. DOI: 10.1038/s41586-020-2012-7.
Wrapp D, Wang N, Corbett KS, et al. Cryo-EM structure of the 2019-nCoV spike in the prefusion conformation. Science 2020;367:1260–1263. DOI: 10.1126/science.abb2507.
Kuba K, Imai Y, Rao S, et al. A crucial role of angiotensin converting enzyme 2 (ACE2) in SARS coronavirus-induced lung injury. Nat Med 2005;11:875–879. DOI: 10.1038/nm1267.
Li Y, Zeng Z, Li Y, et al. Angiotensin-converting enzyme inhibition attenuates lipopolysaccharide-induced lung injury by regulating the balance between angiotensin-converting enzyme and angiotensin-converting enzyme 2 and inhibiting mitogen-activated protein kinase activation. Shock 2015;43:395–404. DOI: 10.1097/SHK.0000000000000302.