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COVID-19 and RAS: Unravelling an Unclear Relationship

Damiano D'Ardes1, Andrea Boccatonda1, Ilaria Rossi1

  • 1Clinica Medica Institute, European Center of Excellence on Atherosclerosis, Hypertension and Dyslipidemia, "G. D'Annunzio" University of Chieti-Pescara, 66100 Chieti, Italy.

International Journal of Molecular Sciences
|April 30, 2020
PubMed

Insights

The renin-angiotensin system (RAS) impacts blood pressure and fluid balance. RAS inhibitors are explored for lung diseases like COVID-19 pneumonia, but their benefits and risks remain uncertain.

Area of Science:

  • Cardiovascular Physiology
  • Pulmonary Medicine
  • Pharmacology

Background:

  • The renin-angiotensin system (RAS) is crucial for blood pressure and fluid homeostasis.
  • RAS modulation is implicated in various lung pathologies, including acute respiratory distress syndrome and fibrosis.
  • The role of RAS inhibitors in COVID-19 pneumonia is under active investigation.

Purpose of the Study:

  • To review the current evidence on the role of the renin-angiotensin system in lung diseases.
  • To evaluate the potential benefits and harms of angiotensin-converting enzyme (ACE) inhibitors and angiotensin receptor 1 (AT1R) inhibitors in COVID-19 pneumonia.

Main Methods:

  • Literature review of existing studies and clinical evidence.
  • Analysis of the physiological mechanisms of RAS in the context of lung injury.
  • Examination of data concerning ACE inhibitors and AT1R inhibitors in pneumonia, particularly COVID-19.

Main Results:

  • The renin-angiotensin system plays a significant role in cardiovascular and pulmonary functions.
  • Evidence suggests potential therapeutic targets within the RAS for lung diseases.
  • Uncertainty persists regarding the net effect of ACE inhibitors and AT1R inhibitors in COVID-19 patients with pneumonia.

Conclusions:

  • The renin-angiotensin system is a key regulator with implications for lung health.
  • RAS-targeting drugs show promise but require further investigation for specific lung conditions.
  • Clarifying the safety and efficacy of RAS inhibitors in COVID-19 pneumonia is essential.
Keywords:
ACEACE2AT1RCOVID-19RASSARS-CoV-2

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