Antagonist Co-Administration of Antiviral Remdesivir with Chloroquine in Patient with COVID-19 Taking ACEI Drug in Hypertension

Abstract

Coronaviruses a positive-sense single-stranded RNA genome ,belong to a family of enveloped viruses that infect humans and animal. They are cause respiratory diseases like severe acute respiratory syndrome coronavirus(SARS), .Middle East respiratory syndrome (MERS) and the emerged severe acute respiratory syndrome coronavirus 2 (SARS-CoV2), the causative agent of the disease “COVID-19”. The protocols of therapy for treatment COVID-19 is used some drugs like hydroxychloroquine, chloroquine phosphate, remdesivir, andlopinavir/ritonavir. The FDA emergency revoked use the combination of hydroxychloroquine and chloroquinein the cure of COVID-19. It has been noted that the patients suffer from cardiovascular disease are increased risk of severe COVID-19. This  may be due to the use of angiotensin-converting enzyme(ACE) inhibitors or blockers of angiotensin receptor (ARBs) in diabetic, hypertensive, or patients suffer from heart failure. This may be explained by the fact that ACE inhibitors and ARBs drugs enhance ACE2 blockers in epithelial cells lining the lung, where SARS-CoV-2is more likely to infect these cells via ACE2 receptors. Similarly, ACEI and ARBs drugs are shown to interact with several antiretroviral drugs leading to increase viral load. The chloroquine have antagonistic effect with remdesivir which leads to decrease therapeutic activity of remdesivir.

Results: The results of  obvious studies  may highlighted the risk of combination therapy of hydroxychloroquine and chloroquine with ACEI and probably with ACE2.

Purpose: The objective of this review is to highlight on the risk of combination use of antiviral drug – Remdesivir – with antimalarial drug – Chloroquine – in patient treated with antihypertensive angiotensin converting enzyme inhibitors drug (ACEI)