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October 2020 Br J Cardiol 2020;27:109–11 doi:10.5837/bjc.2020.031

Neprilysin inhibitors and angiotensin(1–7) in COVID-19

Nathalie Esser, Sakeneh Zraika

Abstract

The issue regarding use of RAS blockers in the context of COVID-19 has previously been reviewed.1,2 Most recently, emerging data suggest no harm is associated with use of ACE inhibitors or ARBs in COVID-19.3,4 In this perspective, we discuss a related aspect that was first raised by Acanfora and colleagues,5 namely, the potential benefit of neprilysin inhibitors and their role in modulating levels of RAS components. Similar to the situation for ACE inhibitors and ARBs, it seems there are mixed opinions on the utility of neprilysin inhibitors in COVID-19. In a recent review, it was postulated that increasing neprilysin activity might mitigate

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