LAUSR

Objective: Since the outbreak of the SARS-COV-2 pandemic, concerns have been raised that RAAS inhibitors (RAAS-i) may increase susceptibility to coronavirus and likelihood of severe COVID-19 illness This study aims to assess the patients' perceptions on the risk or benefit of RAAS-I use focusing on the differences between the two waves of the pandemic in Northern Greece Design and method: Patients visiting the emergency (non-COVID) department or the outpatient clinics of a tertiary hospital were invited to participate by completing a short questionnaire This observational study was conducted during the first (April to June 2020) and the much more forceful second wave (November 2020) of the COVID-19 pandemic Results: In total 341 patients (183 women, 53 7%) taking angiotensin-converting enzyme inhibitors (ACEIs) or angiotensin II receptor type 1 blockers (ARBs) participated (mean age 64 7±9 7 years) About half the patients (188, 55 1%) were taking RAAS-i for hypertension, while the rest for other indications (heart failure, coronary artery disease, etc ) The vast majority (319, 93 5%) were aware of the issue that some antihypertensive drugs might be harmful (mainly from TV reports) Several differences were noted between the participants of the first and the second wave (Table 1) In particular, more patients of the second wave, than of the first wave, knew if they were taking RAAS-I and had contacted their doctor with eventually 14 of them altering their therapeutic regimen Moreover, the second wave patients, in contrast to the first wave participants, reported higher chances of getting COVID-19, with the majority of them believing they are more susceptible to SARS-COV-2 and expecting more severe disease course Disturbingly, only few of the patients of the second wave and none of the first had been informed of the position of major scientific societies that patients should continue taking RAAS-i Conclusions: Greek patients are aware of the issue relating the RAAS-i with the COVID-19 pandemic Second wave participants seem more worried, seeking medical advice and inquiring drug substitution Nevertheless they still lack information from scientific societies Further research is warranted to assess whether patient oriented informative campaigns could comfort their concerns