Clinical effects are unpredictable, so treatment decisions must be tailored and pragmatic Covid-19, which is caused by the single stranded RNA coronavirus SARS-CoV-2, poses therapeutic dilemmas. Some suggestions for drug treatment seem problematic.1 They include various antiviral drugs, some of which have primary targets that are DNA viruses not RNA; immunomodulatory drugs, which may suppress potentially protective acute inflammatory responses and do not specifically target the virus; the antimalarial drugs chloroquine and hydroxychloroquine, which have some antiviral activity in vitro but no evidence of clinical benefit in human viral infections and also have many adverse effects; and corticosteroids, which may be harmful when used to treat infection with the related virus SARS-CoV-1.2 Important questions have also been raised about the use of angiotensin converting enzyme (ACE) inhibitors and angiotensin receptor blockers (ARBs). Do they have a role in treating covid-19? Should people currently taking them continue doing so, and should they stop if they become infected? No trial evidence is yet available on the effects of ACE inhibitors or ARBs in treating covid-19. But for people …

中文翻译：

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药物和covid-19中的肾素-血管紧张素系统

临床效果是不可预测的，因此必须调整治疗决策，由单链RNA冠状病毒SARS-CoV-2引起的务实的Covid-19会带来治疗难题。一些关于药物治疗的建议似乎有问题。1它们包括各种抗病毒药物，其中某些药物的主要靶标是DNA病毒而不是RNA。免疫调节药物，可以抑制潜在的保护性急性炎症反应，并且不专门针对病毒；抗疟药氯喹和羟氯喹在体外具有一定的抗病毒活性，但没有证据表明其对人类病毒感染具有临床益处，并且还具有许多不良反应；和皮质类固醇，当用于治疗相关病毒SARS-CoV-1的感染时可能有害。2关于使用血管紧张素转化酶（ACE）抑制剂和血管紧张素受体阻滞剂（ARB）的问题也提出了重要的问题。他们在治疗covid-19中有作用吗？目前正在服药的人应该继续这样做吗？如果他们被感染了，应该停下来吗？ACE抑制剂或ARB在治疗covid-19中的作用尚无试验证据。但是对于人们……