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Swapnil Hiremath and Matthew A. Sparks

Severe acute respiratory coronavirus 2 (SARS-CoV-2) uses angiotensin-converting enzyme 2 (ACE2) to enter host cells. Early in the pandemic, several basic science studies were often cited and suggested that ACE inhibitors (ACEis) and angiotensin receptor blockers (ARBs) may have an effect to increase the abundance of ACE2 (1). Thus, logic would prevail that if anyone on ACEis or ARBs is at risk of infection, becomes infected, or develops coronavirus infectious disease 2019 (COVID-19), then these should be discontinued. However, the science of the renin angiotensin system (RAS) is far more intricate and interesting. The correct answer is that