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Cardiovascular Pharmacology in the Time of COVID-19: A Focus on Angiotensin-Converting Enzyme 2

Leo F Buckley1, Judy W M Cheng1,2, Akshay Desai3

  • 1Department of Pharmacy Services, Brigham and Women's Hospital, Boston, MA.

Journal of Cardiovascular Pharmacology
|April 18, 2020
PubMed

Insights

This review examines the role of angiotensin-converting enzyme 2 (ACE2) in COVID-19 and cardiovascular disease. It informs management of patients on renin-angiotensin aldosterone system inhibitors during the SARS-CoV-2 pandemic.

Area of Science:

  • Cardiology
  • Infectious Diseases
  • Pharmacology

Background:

  • Coronavirus disease-2019 (COVID-19), caused by SARS-CoV-2, is a global pandemic.
  • Severe acute respiratory syndrome coronavirus-2019 (SARS-CoV-2) utilizes angiotensin-converting enzyme 2 (ACE2) for host cell entry.
  • ACE2 upregulation may offer protection in acute lung injury.

Purpose of the Study:

  • To review the role of ACE2 in cardiovascular physiology and SARS-CoV-2 infection.
  • To synthesize current clinical data regarding ACE2 and COVID-19 management.
  • To guide therapy for patients on renin-angiotensin aldosterone system inhibitors at risk for COVID-19.

Main Methods:

  • Literature review of preclinical and clinical studies.
  • Analysis of the interplay between ACE2, cardiovascular disease, and SARS-CoV-2.
  • Synthesis of data to inform clinical practice.

Main Results:

  • ACE2 plays a critical role in both cardiovascular homeostasis and SARS-CoV-2 pathogenesis.
  • Renin-angiotensin aldosterone system inhibitors may influence ACE2 levels.
  • Understanding ACE2 is crucial for managing COVID-19 patients with cardiovascular conditions.

Conclusions:

  • ACE2 is a key mediator in COVID-19 and cardiovascular disease.
  • Careful consideration of renin-angiotensin aldosterone system inhibitors is needed in COVID-19 patients.
  • Further research is warranted to optimize treatment strategies.

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