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10.1093/cid/ciaa329

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32215613!7184340!32215613
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suck abstract from ncbi


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pmid32215613      Clin+Infect+Dis 2020 ; 71 (15): 870-874
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  • Is There an Association Between COVID-19 Mortality and the Renin-Angiotensin System? A Call for Epidemiologic Investigations #MMPMID32215613
  • Hanff TC; Harhay MO; Brown TS; Cohen JB; Mohareb AM
  • Clin Infect Dis 2020[Jul]; 71 (15): 870-874 PMID32215613show ga
  • Mortality from coronavirus disease 2019 (COVID-19) is strongly associated with cardiovascular disease, diabetes, and hypertension. These disorders share underlying pathophysiology related to the renin-angiotensin system (RAS) that may be clinically insightful. In particular, activity of the angiotensin-converting enzyme 2 (ACE2) is dysregulated in cardiovascular disease, and this enzyme is used by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) to initiate the infection. Cardiovascular disease and pharmacologic RAS inhibition both increase ACE2 levels, which may increase the virulence of SARS-CoV-2 within the lung and heart. Conversely, mechanistic evidence from related coronaviruses suggests that SARS-CoV-2 infection may downregulate ACE2, leading to toxic overaccumulation of angiotensin II that induces acute respiratory distress syndrome and fulminant myocarditis. RAS inhibition could mitigate this effect. With conflicting mechanistic evidence, we propose key clinical research priorities necessary to clarify the role of RAS inhibition in COVID-19 mortality that could be rapidly addressed by the international research community.
  • |Angiotensin II/metabolism[MESH]
  • |Angiotensin-Converting Enzyme 2[MESH]
  • |Betacoronavirus/pathogenicity[MESH]
  • |COVID-19[MESH]
  • |Cardiovascular Diseases/metabolism/virology[MESH]
  • |Coronavirus Infections/epidemiology/*metabolism/*mortality/virology[MESH]
  • |Humans[MESH]
  • |Pandemics[MESH]
  • |Peptidyl-Dipeptidase A/metabolism[MESH]
  • |Pneumonia, Viral/epidemiology/*metabolism/*mortality/virology[MESH]
  • |Renin-Angiotensin System/*physiology[MESH]
  • |SARS-CoV-2[MESH]


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