Data from China, where the disease emerged, indicate that a significant proportion on non-survivors and those who developed severe disease had comorbidities such as diabetes and hypertension. The exact reason for this remains unclear. It is likely both hypertension and diabetes are prevalent in the general population particularly in the age group (over 70 years) where the mortality from COVID-19 infection is highest.
There has been an article linking this observation to the use of Angiotensin converting enzyme (ACE) inhibitors and angiotensin II receptor blockers (A2RB/ARB) which are common medications used to treat high blood pressure.7 It is important to emphasise that this is a theory which has yet to be substantiated by evidence. Major health organisations such as the European Society of Cardiology, British Cardiac Society and the American Heart Association recommend continuing these medications (since their beneficial effects are well known) whilst monitoring the disease progress of patients with hypertension and diabetes.8,9
