The renin-angiotensin-aldosterone system and covid-19. From basis to therapeutics

ABSTRACT

Severe acute respiratory syndrome coronavirus 2, which is responsible for the current coronavi-rus disease 2019 pandemic, uses angiotensin-converting enzyme 2 as a gateway into host cells. In this review, we summarized the biology of this enzyme which plays a key role in cardiovascular homeostasis and blood pressure control. Blockers of the renin-angiotensin-aldosterone system modify the expression and activity of angiotensin-converting enzyme 2, possibly in different ways. The effects of angiotensin-converting enzyme inhibitors and angiotensin receptor blockers on the expression and enzyme activity of angiotensin-converting enzyme 2 are reviewed, and the consequences of these treatments for the severity of coronavirus disease 2019 infection are discussed. © 2020, John Libbey. All rights reserved.