Clinical Implications of SARS-CoV-2 Interaction With Renin Angiotensin System: JACC Review Topic of the Week.
J Am Coll Cardiol
; 75(24): 3085-3095, 2020 06 23.
Article
in English
| MEDLINE | ID: covidwho-598624
ABSTRACT
Severe acute respiratory-syndrome coronavirus-2 (SARS-CoV-2) host cell infection is mediated by binding to angiotensin-converting enzyme 2 (ACE2). Systemic dysregulation observed in SARS-CoV was previously postulated to be due to ACE2/angiotensin 1-7 (Ang1-7)/Mas axis downregulation; increased ACE2 activity was shown to mediate disease protection. Because angiotensin II receptor blockers, ACE inhibitors, and mineralocorticoid receptor antagonists increase ACE2 receptor expression, it has been tacitly believed that the use of these agents may facilitate viral disease; thus, they should not be used in high-risk patients with cardiovascular disease. Based on the anti-inflammatory benefits of the upregulation of the ACE2/Ang1-7/Mas axis and previously demonstrated benefits of lung function improvement in SARS-CoV infections, it has been hypothesized that the benefits of treatment with renin-angiotensin system inhibitors in SARS-CoV-2 may outweigh the risks and at the very least should not be withheld.
Keywords
Full text:
Available
Collection:
International databases
Database:
MEDLINE
Main subject:
Pneumonia, Viral
/
Angiotensin-Converting Enzyme Inhibitors
/
Cardiovascular Diseases
/
Coronavirus Infections
/
Peptidyl-Dipeptidase A
/
Mineralocorticoid Receptor Antagonists
/
Angiotensin Receptor Antagonists
/
Pandemics
/
Betacoronavirus
Type of study:
Prognostic study
Limits:
Humans
Language:
English
Journal:
J Am Coll Cardiol
Year:
2020
Document Type:
Article
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