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Association of ACE2 receptor and ACEIs/ARBs with disease severity in COVID-19

Shweta Sinha1, Alka Sehgal2, Rakesh Sehgal1

  • 1Department of Medical Parasitology, PGIMER, Chandigarh, India.

Drug Discoveries & Therapeutics
|September 10, 2020
PubMed

Insights

This review examines how the renin-angiotensin-aldosterone system (RAAS) impacts COVID-19 severity, particularly concerning RAAS inhibitors like ACE inhibitors and ARBs. It explores ACE2 expression and its link to comorbidities in COVID-19 patients.

Area of Science:

  • Cardiology
  • Infectious Diseases
  • Pharmacology

Background:

  • COVID-19 frequently co-occurs with cardiovascular diseases, hypertension, and diabetes.
  • Dysregulation of the renin-angiotensin-aldosterone system (RAAS) is observed in COVID-19 patients.
  • The impact of RAAS inhibitors (ACEIs, ARBs) on COVID-19 clinical outcomes is uncertain.

Purpose of the Study:

  • To review the role of angiotensin-converting enzyme 2 (ACE2) in COVID-19 progression.
  • To investigate the association between ACE2, comorbidities, and COVID-19.
  • To summarize clinical evidence regarding ACEIs/ARBs in COVID-19 management.

Main Methods:

  • Literature review of existing studies on COVID-19, RAAS, ACE2, and related comorbidities.
  • Analysis of the role of ACE2 expression in disease pathogenesis.
  • Synthesis of clinical evidence concerning RAAS inhibitors in COVID-19 patients.

Main Results:

  • ACE2 plays a critical role in COVID-19 pathogenesis and disease progression.
  • Comorbidities like hypertension and diabetes are linked to altered ACE2 expression.
  • The clinical effects of ACEIs and ARBs in COVID-19 patients require further investigation.

Conclusions:

  • Understanding ACE2's role is crucial for managing COVID-19 patients with comorbidities.
  • Further research is needed to clarify the safety and efficacy of ACEIs/ARBs in COVID-19.
  • This review highlights key areas for future clinical studies on RAAS inhibitors and COVID-19.

Keywords:
ACE2ACEIsARBsCOVID-19comorbidities

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