The angiotensin II type 1 receptor blocker valsartan in the battle against COVID‐19

de Ligt, Marlies; Hesselink, Matthijs K.C.; Jorgensen, Johanna; Jocken, Johan W.E.; Blaak, Ellen E.; Goossens, Gijs H.

OBJECTIVE: SARS‐CoV‐2 uses the hosts angiotensin‐converting enzyme 2 (ACE2) as cellular entry point. Hence, modulating ACE2 might impact SARS‐CoV‐2 viral replication, shedding and COVID‐19 severity. Here, we investigated if the angiotensin II type 1 receptor (AT1R) blocker valsartan alters the expression of renin‐angiotensin system (RAS) components, including ACE2, in human adipose tissue (AT) and skeletal muscle. METHODS: We performed a randomized, double‐blind, placebo‐controlled clinical trial, in which 36 participants (BMI 31.0±0.8 kg/m(2)) with impaired glucose metabolism received either valsartan or placebo for 26 weeks. Before and after 26 weeks treatment, abdominal subcutaneous AT and skeletal muscle biopsies were obtained, and gene expression of RAS components was measured by qRT‐PCR. RESULTS: Valsartan treatment did not significantly impact the expression of RAS components, including ACE2, in AT and skeletal muscle. CONCLUSIONS: Given the pivotal role of ACE2 in SARS‐CoV‐2 spread and the clinical outcomes in COVID‐19 patients, our data suggest that the putative beneficial effects of ARBs on the clinical outcomes in patients with COVID‐19 may not be mediated through altered ACE2 expression in abdominal subcutaneous AT.