As a layperson, It's really difficult to figure this issue out and one reason is there is no data to support the hypothesis promoted by the Lancet article. 

>Patients with COVID-19 Should Continue ACE Inhibitors and ARBs: A Joint Statement from U.S. Heart Groups
Karol E. Watson, MD, PhD, FACC reviewing 2020 Mar 17 Fang L et al. Lancet Respir Med 2020 Mar 11

>There is no clinical evidence of a connection between the medications and risk for illness.

>Patients with novel coronavirus disease (COVID-19) who have underlying hypertension, heart failure, or ischemic heart disease should not stop taking their angiotensin-converting–enzyme (ACE) inhibitors or angiotensin-receptor blockers (ARBs), according to a new statement from the American Heart Association, the American College of Cardiology, and the Heart Failure Society of America.

>Previously, in a letter published in Lancet Respiratory Medicine, researchers proposed that ACE inhibitors and ARBs could increase the risk for developing severe COVID-19. The coronavirus binds to target cells through ACE2, the expression of which is increased when patients take these drugs.

— Adapted from a Physician's First Watch article, published on March 17, 2020

>COMMENT
The virus that causes COVID-19 enters the lungs through ACE2, and renin-angiotensin-aldosterone system (RAAS) blockers increase the expression of ACE2. However, no clinical data exist to support the hypothesis that utilization of RAAS blockers could increase the ability of the virus to enter the lungs. This statement from the three U.S. professional cardiology groups should give clinicians comfort in continuing to use RAAS blockers during these strange and unsettling times.

Bill Hesbach
Cheshire CT

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