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Angiotensin-converting enzyme 2 and COVID-19: patients, comorbidities, and therapies
Girish Pathangey1, Priyal P Fadadu2, Alexandra R Hospodar1
1William Beaumont School of Medicine, Oakland University, Rochester, Michigan.
Insights
This review examines how angiotensin-converting enzyme 2 (ACE2) receptors influence COVID-19 susceptibility and severity. It explores links between ACE2, comorbidities, risk factors, and therapies, identifying knowledge gaps for future research.
Area of Science:
- Medical Science
- Infectious Diseases
- Epidemiology
Background:
- The COVID-19 pandemic, declared by WHO in March 2020, presents with highly variable clinical manifestations.
- Angiotensin-converting enzyme 2 (ACE2) receptors and various comorbidities are implicated in COVID-19 susceptibility and disease progression.
Purpose of the Study:
- To review existing evidence on the relationship between ACE2, common comorbidities, risk factors, and therapies.
- To assess the impact of these factors on COVID-19 susceptibility and severity.
- To identify knowledge gaps requiring further investigation.
Main Methods:
- Systematic review of evidence.
- Analysis of the association between ACE2 receptors and COVID-19.
- Evaluation of comorbidities, risk factors, and therapies related to COVID-19.
Main Results:
- Strong evidence links primary comorbidities (respiratory, cardiovascular, renal diseases, diabetes, obesity, hypertension) to COVID-19.
- Limited-to-moderate evidence connects secondary risk factors (age, sex, race/genetics) and tertiary factors (ACE inhibitors, ARBs) to COVID-19.
- Limited evidence suggests associations with ibuprofen and thiazolidinediones.
Conclusions:
- ACE2 receptors, comorbidities, and certain risk factors significantly influence COVID-19 susceptibility and severity.
- Further research is needed to fully elucidate these complex relationships and inform clinical practice.
Abstract:
On March 11, 2020, the World Health Organization declared coronavirus disease 2019 (COVID-19) a pandemic, and the reality of the situation has finally caught up to the widespread reach of the disease. The presentation of the disease is highly variable, ranging from asymptomatic carriers to critical COVID-19. The availability of angiotensin-converting enzyme 2 (ACE2) receptors may reportedly increase the susceptibility and/or disease progression of COVID-19. Comorbidities and risk factors have also been noted to increase COVID-19 susceptibility. In this paper, we hereby review the evidence pertaining to ACE2's relationship to common comorbidities, risk factors, and therapies associated with the susceptibility and severity of COVID-19. We also highlight gaps of knowledge that require further investigation. The primary comorbidities of respiratory disease, cardiovascular disease, renal disease, diabetes, obesity, and hypertension had strong evidence. The secondary risk factors of age, sex, and race/genetics had limited-to-moderate evidence. The tertiary factors of ACE inhibitors and angiotensin II receptor blockers had limited-to-moderate evidence. Ibuprofen and thiazolidinediones had limited evidence.
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