The link between ACE-inhibitor cough and covid-19 cough

Retired GP and researcher Dr Colin Brown realised that the similarities between the ACEI cough and covid-19 cough suggested a common cause and this could have implications for treatment.

A colleague’s observation that full dose (600mg) aspirin stopped his ACE-inhibitor (ACEI) induced cough, and the report of indomethacin suppressing the cough of covid-19 prompted Dr Brown to investigate whether the two types of cough arose from a similar cause. He realised that the ACEI cough and the covid cough had many similarities – both are dry, hacking, unproductive, persistent and can be exhausting. Moreover, they are unresponsive to conventional antitussives, abnormalities of smell and taste are common to both, and they share a racial profile.

Suppression of the ACEI cough with aspirin has been reported previously¹ but it is rarely prescribed for this indication because it makes more sense to stop the ACEI.

Dr Brown reported his findings in the BMJ in July 2020.²

Reference

1. Tenenbaum AT, Grossman E, Shemesh J et al. Intermediate but not low doses of aspirin can suppress angiotensin-converting enzyme inhibitor-induced cough. Am J Hypertens 2000;13:776-782
2. Brown C, Griffiths G. Non-steroidal anti-inflammatory drugs and covid-19: Indomethacin or aspirin? https://www.bmj.com/content/368/bmj.m1185/rr-5