COVID-19 pathophysiology may be driven by an imbalance in the renin-angiotensin-aldosterone system.
Nat Commun
; 12(1): 2417, 2021 04 23.
Artículo
en Inglés
| MEDLINE | ID: covidwho-1203428
ABSTRACT
SARS-CoV-2 uses ACE2, an inhibitor of the Renin-Angiotensin-Aldosterone System (RAAS), for cellular entry. Studies indicate that RAAS imbalance worsens the prognosis in COVID-19. We present a consecutive retrospective COVID-19 cohort with findings of frequent pulmonary thromboembolism (17%), high pulmonary artery pressure (60%) and lung MRI perfusion disturbances. We demonstrate, in swine, that infusing angiotensin II or blocking ACE2 induces increased pulmonary artery pressure, reduces blood oxygenation, increases coagulation, disturbs lung perfusion, induces diffuse alveolar damage, and acute tubular necrosis compared to control animals. We further demonstrate that this imbalanced state can be ameliorated by infusion of an angiotensin receptor blocker and low-molecular-weight heparin. In this work, we show that a pathophysiological state in swine induced by RAAS imbalance shares several features with the clinical COVID-19 presentation. Therefore, we propose that severe COVID-19 could partially be driven by a RAAS imbalance.
Texto completo:
Disponible
Colección:
Bases de datos internacionales
Base de datos:
MEDLINE
Asunto principal:
Sistema Renina-Angiotensina
/
SARS-CoV-2
/
COVID-19
/
Pulmón
Tipo de estudio:
Estudio de cohorte
/
Estudio observacional
/
Estudio pronóstico
Límite:
Animales
/
Femenino
/
Humanos
Idioma:
Inglés
Revista:
Nat Commun
Asunto de la revista:
Biologia
/
Ciencia
Año:
2021
Tipo del documento:
Artículo
País de afiliación:
S41467-021-22713-z
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