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Renin-angiotensin system blockers and severe acute respiratory syndrome coronavirus 2

Bernard I Lévy1, Jean-Pierre Fauvel2,

  • 1Inserm UMR970 (PARCC) and Hôpital Lariboisière, 75010 Paris, France.

Archives of Cardiovascular Diseases
|September 1, 2020
PubMed

Insights

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) uses angiotensin-converting enzyme 2 (ACE2) to infect cells. This review examines ACE2 biology and how renin-angiotensin system blockers affect SARS-CoV-2 severity.

Area of Science:

  • Cardiovascular Biology
  • Virology
  • Pharmacology

Background:

  • Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) utilizes angiotensin-converting enzyme 2 (ACE2) as its primary entry receptor into host cells.
  • ACE2 is a crucial enzyme in maintaining cardiovascular homeostasis.
  • The coronavirus disease 2019 (COVID-19) pandemic highlights the importance of understanding ACE2's role.

Purpose of the Study:

  • To review the fundamental biology of angiotensin-converting enzyme 2 (ACE2).
  • To analyze how renin-angiotensin system (RAS) blockers influence ACE2 expression and activity.
  • To discuss the implications of these drug effects on COVID-19 severity.

Main Methods:

  • Literature review of studies on ACE2 biology.
  • Analysis of research on the impact of ACE inhibitors (ACEi) and angiotensin receptor blockers (ARBs) on ACE2.
  • Synthesis of findings regarding the relationship between RAS blockade and COVID-19 outcomes.

Main Results:

  • Renin-angiotensin system blockers differentially modulate ACE2 expression and activity.
  • ACE inhibitors and ARBs have distinct effects on ACE2 levels and function.
  • The impact of these modulations on COVID-19 severity is a critical area of investigation.

Conclusions:

  • Understanding ACE2's interaction with SARS-CoV-2 is vital for managing COVID-19.
  • The effects of RAS blockers on ACE2 warrant careful consideration in clinical practice.
  • Further research is needed to elucidate the precise consequences of RAS blockade for COVID-19 patients.
Keywords:
Angiotensin receptor blockersAngiotensin-converting enzyme inhibitorsArterial hypertensionBloqueur des récepteurs de l’angiotensineHeart failureHypertension artérielleInhibiteurs de l’enzyme de conversion de l’angiotensineInsuffisance cardiaque

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