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Response to the emerging novel coronavirus outbreak

BMJ 2020; 368 doi: (Published 31 January 2020) Cite this as: BMJ 2020;368:m406

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Use of angiotensin receptor blockers such as Telmisartan, Losartsan in nCoV Wuhan Corona Virus infections – Novel mode of treatment

Against the backdrop of the rapid spread of novel corona virus infection from Wuhan, China, to large areas globally and that besides supportive management, no novel modalities of treatment have been offered, we suggest the use of angiotensin II receptor blockers as a treatment for this infection.

Yushun Wan, Jian Shang et al [1] have analysed the potential receptor usage by 2019- nCoV based on the knowledge on sequencing of SARS- CoV. They have found that the sequence of 2019 nCoV receptor binding motif that directly contacts ACE2 (receptor Angiotensin converting enzyme 2) is similar to that of SARS–CoV & suggest that 2019-nCoV (Wuhan) uses ACE2 as its receptor. Their structural analysis predicted that the Wuhan Corona Virus uses ACE2 as its host receptor. They have further stated that a single mutation significantly enhances the ability of nCoV (Wuhan) to bind with human ACE2.

Based on this, we hypothesize the use of angiotensin II receptor blockers (ARB) available for clinical use can be potential drugs to be given for control of viral spread of novel corona virus (Wuhan) infection. An unpublished observation by one of us (MP) is that people using Losartan or Telmisartan tablets as antihypertensives get lesser attacks of cold & flu like illnesses. Both these drugs also do not produce cough as the side effect so commonly seen with ACE inhibitors.

Losartan and Telmisartan strongly bind to the AT1 receptors more than Valsartan [2]. Therefore, use of the former could be suitable in treatment of novel corona virus (Wuhan, China) infections. Mode of administration in addition to being given orally, could be in the form of a nasal spray. Published literature is scant on this information. Clinicians and scientists may consider use of Losartan or Telmisartan in therapeutic doses for preventing the nCov virus entering the host cell and spread of infection. Rapid clinical trials are the need of the hour.

M Phadke [1], S Saunik [2]

[1] Sr. Advisor, N.H.M., Govt. of Mah. & UNICEF, Ex-Vice Chancellor, Maharashtra Uni. Health Sciences, Mah., India

[2] Addl. Chief Secretary, Govt. Maharashtra, Mumbai, India, Takemi fellow, T.H.C. School of Pub. Health, Harvard University, USA

We declare no conflict of interest.


1. Yushun Wan, Jian Shang, Rachel Graham, Ralph S Baric, Fang Li. Receptor recognition by novel coronavirus from Wuhan: an analysis based on decade-long structural studies of SARS. Journal of Virology, 2020; DOI: 10.1128/JVI.00127-20.

2. Hardman Lee Limbard, Goodman Gilman’s. The pharmacological basis of therapeutics 2001; 829-832.

Competing interests: No competing interests

04 February 2020
M. A. Phadke
Prof. Dr.
S Saunik
Mumbai, India