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Related Experiment Video

Updated: Dec 25, 2025

Live Imaging and Quantification of Viral Infection in K18 hACE2 Transgenic Mice Using Reporter-Expressing Recombinant SARS-CoV-2
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COVID-19, ACE2, and the cardiovascular consequences.

Andrew M South1, Debra I Diz1, Mark C Chappell1

  • 1Cardiovascular Sciences Center, Wake Forest School of Medicine, Winston-Salem, North Carolina.

American Journal of Physiology. Heart and Circulatory Physiology
|April 2, 2020
PubMed
Summary

The SARS-CoV-2 virus uses angiotensin-converting enzyme 2 (ACE2) to infect cells. This review examines how cardiovascular disease (CVD) medications like RAAS blockers and statins affect ACE2 and COVID-19 risks.

Keywords:
ACE2ANG IICOVID-19SARS-CoV-2renin-angiotensin systemstatins

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Area of Science:

  • Cardiovascular Medicine
  • Infectious Diseases
  • Pharmacology

Background:

  • The SARS-CoV-2 pandemic poses significant risks to patients with cardiovascular disease (CVD).
  • SARS-CoV-2 infection mechanism involves binding to angiotensin-converting enzyme 2 (ACE2), a key enzyme in the renin-angiotensin-aldosterone system (RAAS).
  • ACE2 plays a crucial role in regulating blood pressure and has protective effects against CVD by degrading angiotensin II (ANG II) and generating Ang-(1-7).

Purpose of the Study:

  • To critically examine the regulation of ACE2 by RAAS blockade and statins.
  • To evaluate the cardiovascular benefits of ACE2.
  • To determine if ACE2 blockade is a viable therapeutic strategy for attenuating COVID-19.

Main Methods:

  • Review of experimental evidence on ACE2 regulation by RAAS blockade and statins.
  • Analysis of the role of ACE2 in cardiovascular health and disease.
  • Examination of potential therapeutic strategies targeting ACE2 for COVID-19.

Main Results:

  • RAAS blockers and statins may enhance ACE2 expression, potentially contributing to their therapeutic benefits.
  • ACE2's role in degrading ANG II and generating Ang-(1-7) highlights its protective cardiovascular functions.
  • Concerns exist regarding the risk of SARS-CoV-2 infection in patients on RAAS blockers and statins.

Conclusions:

  • The interaction between SARS-CoV-2, ACE2, and RAAS blockade requires careful consideration in patient management.
  • Further research is needed to clarify the net effects of RAAS blockade and statins on COVID-19 outcomes.
  • Targeting ACE2 warrants investigation as a potential therapeutic approach for COVID-19.