ACE2 and heart failure: This is primarily driven by concern that these medications increase ACE2 expression, although this has only been demonstrated in animal models.44,45 In patients with heart failure, the use of ACE inhibitors and ARBs has not been found to increase the plasma levels of ACE2.46 Conversely, in animal models, ACE2 has been shown to be downregulated in the setting of infection with SARS-CoV.