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COVID-19 and the renin-angiotensin system (RAS): A spark that sets the forest alight?
Wiese, O J; Allwood, B W; Zemlin, A E.
  • Wiese OJ; Division of Chemical Pathology, Department of Pathology, National Health Laboratory Service (NHLS) & Stellenbosch University, Tygerberg Hospital, Cape Town, South Africa.
  • Allwood BW; Division of Pulmonology, Department of Medicine, Stellenbosch University & Tygerberg Hospital, South Africa.
  • Zemlin AE; Division of Chemical Pathology, Department of Pathology, National Health Laboratory Service (NHLS) & Stellenbosch University, Tygerberg Hospital, Cape Town, South Africa. Electronic address: azemlin@sun.ac.za.
Med Hypotheses ; 144: 110231, 2020 Nov.
Article in English | MEDLINE | ID: covidwho-741425
ABSTRACT
The coronavirus disease 2019 (COVID-19) pandemic has increased exponentially in numbers with more than 20 million people infected around the globe. It is clear that COVID-19 is not a simple viral pneumonia, but presents with unusual pathophysiological effects. Of special interest is that SARS-CoV-2 utilises the angiotensin-converting enzyme-2 (ACE2) for cell entry and therefore has a direct effect on the renin angiotensin system (RAS). The RAS is primarily responsible for blood pressure control via the classic pathway. Recently numerous other pathological processes have been described due to stimulation of this classic pathway. There is also a protective RAS pathway medicated by ACE2 which may be suppressed in COVID-19. This leads to overstimulation of the classic pathway with adverse cardiovascular and respiratory effects, hypercoagulation, endothelial dysfunction, inflammation and insulin resistance. We hypothesize that overreaction of the renin-angiotensin-aldosterone may account for the myriad of unusual biochemical and clinical abnormalities noted in patients infected with SARS-CoV-2.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: Renin-Angiotensin System / Gene Expression Regulation / COVID-19 / Inflammation Type of study: Prognostic study Topics: Long Covid Limits: Aged / Female / Humans / Male Language: English Journal: Med Hypotheses Year: 2020 Document Type: Article Affiliation country: J.mehy.2020.110231

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Renin-Angiotensin System / Gene Expression Regulation / COVID-19 / Inflammation Type of study: Prognostic study Topics: Long Covid Limits: Aged / Female / Humans / Male Language: English Journal: Med Hypotheses Year: 2020 Document Type: Article Affiliation country: J.mehy.2020.110231