Objective: Since the outbreak of the SARS-COV-2 pandemic, concerns have been raised that renin-angiotensin-aldosterone system inhibitors (RAAS-i) may increase the susceptibility to the coronavirus and the likelihood of severe COVID-19 illness. Aim of this study was to assess the patients' perceptions on the risk or benefit of RAAS-I use in the COVID-19 era. Design and method: Patients visiting the emergency (non-COVID) department or the outpatient clinics of a tertiary hospital in Northern Greece were invited to participate by completing a short questionnaire. This observational study was conducted during the first wave of the COVID-19 (April to June 2020) and would restart at an imminent second wave. Analyses included only questionnaires from the first wave (which was apparently well controlled in Greece) and were performed by IBM SPSS Statistics. Results: In total 178 patients (94 women, 52.8%) taking angiotensin-converting enzyme inhibitors (ACEIs) or angiotensin II receptor type 1 blockers (ARBs) participated (mean age 63.8±10.2 years). About half (97, 54.4%) were taking RAASi for hypertension, while the rest for other indications. The vast majority (160, 92.1%) were aware of the issue that some antihypertensive drugs might be harmful (mainly from TV reports), although almost one third (51, 31.9%) were not sure if they were prescribed such drugs. One fifth of the patients had contacted their doctor inquiring if they were taking such drugs and if, in that case, they could replace it. Only three patients altered their therapeutic regimen. Of note, the majority of patients (151, 84.8%) reported that the chances of getting COVID-19 were low or somewhat low, though they feel more susceptible to catch it (128, 65.7%) or that they will have a more severe disease course (136, 76.4%). Disturbingly, none of the patients had been informed of the position of major scientific societies that patients should not stop taking RAAS-i. Conclusions: Greek patients appear to be aware of the issue relating the RAAS-i with the COVID-19 pandemic. Nevertheless they seem lacking information from their healthcare providers or from scientific bodies. Further research is warranted to assess whether patient oriented informative campaigns could comfort the concerns.
Patients' perceptions on the use of renin-angiotensinaldosterone system inhibitors during the first wave of the COVID-19 pandemic