Angiotensin-converting enzyme 2 (ACE2) as a SARS-CoV-2 receptor: molecular mechanisms and potential therapeutic target

Cardiovascular Considerations for Patients, Health Care Workers, and Health Systems During the COVID-19 Pandemic

“…After ligand binding, SARS-CoV2 enters cells via receptor-mediated endocytosis in a manner akin to human immunodeficiency virus (HIV) (10). ACE2 also serves a role in lung protection and therefore viral binding to this receptor deregulates a lung protective pathway, contributing to viral pathogenicity (11). Figure 1 depicts the potential mechanisms for ACE2 with regard to viral pathogenicity and lung protection, as well as the potential effects on this from renin-angiotensinaldosterone inhibition as noted in the section on Drug Therapy and COVID-19 below.…”

Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2): An overview of viral structure and host response

“…These include camostat mesylate which is a serine protease inhibitor that can inhibit the performance of TMPRSS2 enzyme activity in the coronavirus entry process. This drug has been used clinically in the treatment of chronic pancreatitis so that it is considered to be a potential therapy for COVID-19 treatment [50][51][52]. In addition to the two therapeutic approaches above, other potential therapeutic development pathways for patients with this viral infection can be done through blocking ACE2 receptors and RNA interference using siRNA or microRNA [52][53][54].…”

Coronavirus Disease (COVID-19): A primer for emergency physicians

“…89,90 There are no clear data supporting harm or benefit with angiotensin converting enzyme inhibitors or ACE receptor blockers (ARBs). 91,92 Unless authorized through a clinically J o u r n a l P r e -p r o o f approved trial or Monitored Emergency Use of Unregistered Interventions Framework (MEURI), unlicensed treatments should not be administered. 62 Continuous renal replacement therapy (CRRT), extracorporeal membrane oxygenation (ECMO), and immunoglobulin have been utilized for management, but have not been definitively shown to be beneficial.…”