Association of ACE2 receptor and ACEIs/ARBs with disease severity in COVID-19

Drug Discov Ther. 2020;14(4):161-170. doi: 10.5582/ddt.2020.03064.

Abstract

Coronavirus disease 2019 (COVID-19) is found to be associated with various comorbidities which include cardiovascular diseases, hypertension, and diabetes. The impaired regulation of renin-angiotensin-aldosterone system (RAAS) has been seen in COVID-19 patients, but whether RAAS inhibitors, such as angiotensin-converting enzyme inhibitors (ACEIs) and angiotensin II type 1 receptor blockers (ARBs), are responsible for worsening of clinical conditions remains unknown. Herein, we review the role of angiotensin-converting enzyme 2 (ACE2) expression in disease progression, its association with comorbidities and COVID-19, and summarize the clinical evidence for several potential directions for future research work on ACEIs/ARBs in COVID-19 patients.

Keywords: ACE2; ACEIs; ARBs; COVID-19; comorbidities.

Publication types

  • Review

MeSH terms

  • Angiotensin Receptor Antagonists / adverse effects
  • Angiotensin-Converting Enzyme 2
  • Angiotensin-Converting Enzyme Inhibitors / adverse effects
  • Antiviral Agents / therapeutic use
  • Betacoronavirus / drug effects
  • Betacoronavirus / pathogenicity*
  • COVID-19
  • COVID-19 Drug Treatment
  • Comorbidity
  • Coronavirus Infections / drug therapy
  • Coronavirus Infections / enzymology
  • Coronavirus Infections / virology*
  • Host Microbial Interactions
  • Humans
  • Pandemics
  • Patient Safety
  • Peptidyl-Dipeptidase A / metabolism*
  • Pneumonia, Viral / drug therapy
  • Pneumonia, Viral / enzymology
  • Pneumonia, Viral / virology*
  • Renin-Angiotensin System* / drug effects
  • Risk Assessment
  • Risk Factors
  • SARS-CoV-2
  • Severity of Illness Index
  • Virus Internalization* / drug effects

Substances

  • Angiotensin Receptor Antagonists
  • Angiotensin-Converting Enzyme Inhibitors
  • Antiviral Agents
  • Peptidyl-Dipeptidase A
  • ACE2 protein, human
  • Angiotensin-Converting Enzyme 2