Interaction of SARS-CoV-2 With RAS / ACE2 in the Female Reproductive System

Farideh Zafari Zangeneh1

  • 1Vali-e-Asr Reproductive Health Research Center, Tehran University of Medical Sciences, Tehran, Iran.

Insights

This review highlights how COVID-19 affects the female reproductive system. The virus enters cells via Angiotensin-Converting Enzyme-2 (ACE2), which is present in reproductive organs, potentially impacting fertility.

Area of Science:

  • Reproductive Endocrinology
  • Virology
  • Infectious Diseases

Background:

  • Coronaviruses, including SARS, MERS, and COVID-19, pose global health challenges.
  • Understanding viral impact on specific organ systems is crucial for public health.
  • The female reproductive system's susceptibility to viral infections requires detailed investigation.

Purpose of the Study:

  • To review current scientific literature on the effects of coronaviruses (SARS, MERS, COVID-19) on the female reproductive tract.
  • To synthesize knowledge regarding viral entry mechanisms and potential reproductive health implications.
  • To highlight the significance of Angiotensin-Converting Enzyme-2 (ACE2) expression in the female reproductive system.

Main Methods:

  • Comprehensive literature search of articles published between 2003 and 2021.
  • Focus on studies investigating the impact of SARS, MERS, and COVID-19 on female reproductive health.
  • Systematic review and synthesis of findings related to viral mechanisms and ACE2 expression.

Main Results:

  • Coronaviruses utilize the spike (S) protein to bind to Angiotensin-Converting Enzyme-2 (ACE2) receptors for cell entry.
  • High ACE2 expression in various tissues, including the reproductive tract, correlates with increased viral infection severity.
  • Evidence indicates widespread ACE2 expression in the ovary, uterus, vagina, and placenta.

Conclusions:

  • The female reproductive tract, including ovaries, uterus, vagina, and placenta, expresses ACE2, making it a potential target for coronaviruses.
  • Viral infection of the female reproductive system may lead to gamete damage, affecting fertility and future generations.
  • Further research is warranted to fully understand and mitigate the reproductive health consequences of COVID-19.

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