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Updated: Nov 8, 2025
Optical Coherence Tomography Based Biomechanical Fluid-Structure Interaction Analysis of Coronary Atherosclerosis Progression
Published on: January 15, 2022
COVID-19 from a cardiovascular perspective
Alfonso Bryce-Moncloa1, Mayte Bryce-Alberti2, Arianna Portmann-Baracco2
1Academia Nacional de Medicina Lima-Perú, Sociedad Latinoamericana de Hipertensión Arterial (LASH), Sociedad Interamericana de Cardiología (SIAC), Comité Editorial en Español de la Revista del Colegio Americano de Cardiología (JACC), Sociedad Internacional de Aterosclerosis (IAS), Colegio Americano de Cardiología, Sociedad Europea de Cardiología, Unidad de Investigación CARDIOGOLF, Lima, Perú.
Insights
Coronavirus disease 2019 (COVID-19) can cause myocardial injury, particularly in severe cases. The renin-angiotensin-aldosterone system, specifically angiotensin-converting enzyme 2 (ACE2), plays a key role in mitigating lung and cardiac damage.
Area of Science:
- Cardiology
- Infectious Diseases
- Pulmonology
Background:
- Myocardial injury is a recognized complication in patients hospitalized with COVID-19.
- Severe COVID-19 is correlated with increased cardiac events.
- The virus progresses from lung infection to systemic inflammation, causing hypoxemia and cardiovascular stress.
Purpose of the Study:
- To explore the role of the renin-angiotensin-aldosterone system in COVID-19 pathophysiology.
- To elucidate the protective mechanisms of angiotensin-converting enzyme 2 (ACE2) in COVID-19.
Main Methods:
- Review of current literature on COVID-19, myocardial injury, and the renin-angiotensin-aldosterone system.
- Analysis of the pathophysiological pathways involved in SARS-CoV-2 infection and systemic inflammation.
Main Results:
- The renin-angiotensin-aldosterone system is implicated in severe COVID-19.
- Angiotensin-converting enzyme 2 (ACE2) mediates vasodilation, cardioprotection, anti-oxidation, and anti-inflammation.
- Free ACE2 inhibits viral binding and reduces lung damage.
Conclusions:
- ACE2 plays a critical protective role against COVID-19-induced lung and myocardial injury.
- Targeting the ACE2 pathway may offer therapeutic strategies for severe COVID-19.
Abstract:
Currently, myocardial injury has been reported in patients hospitalized with coronavirus disease 2019 (COVID-19). The studies also show a correlation between cardiac events and severe forms of the disease. COVID-19 begins with an early infection phase in which the virus infiltrates the lung parenchyma and proliferates. It then progresses to the pulmonary phase, where the initial inflammatory process, characterized by vasodilation, vascular permeability, and leukocyte recruitment, leads to lung damage, hypoxemia, and cardiovascular stress. The renin angiotensin aldosterone system is important in the pathophysiology of severe acute respiratory syndrome coronavirus 2 infection and in the propagation of systemic inflammation. Within this system, the pathway mediated by angiotensin-converting enzyme 2 (ACE2) produces vasodilation, cardioprotection, anti-oxidation, and anti-inflammation. Furthermore, the free form of ECA2 prevents binding of the virus to host cells and reduces its damage to the lung.
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