Coronavirus disease 2019 (COVID-19) and the renin-angiotensin system: A closer look at angiotensin-converting enzyme 2 (ACE2)

Abstract

Since the first cases of atypical pneumonia linked to the Huanan Seafood Wholesale Market in Wuhan, China, were described in late December 2019, the global landscape has changed radically. In March 2020, the World Health Organization declared COVID-19 a global pandemic, and at the time of writing this review, just over three million individuals have been infected with more than 200,000 deaths globally. Numerous countries are in 'lockdown', social distancing is the new norm, even the most advanced healthcare systems are under pressure, and a global economic recession seems inevitable. A novel coronavirus (SARS-CoV-2) was identified as the aetiological agent. From experience with previous coronavirus epidemics, namely the severe acute respiratory syndrome (SARS) and Middle East Respiratory Syndrome (MERS) in 2004 and 2012 respectively, it was postulated that the angiotensin-converting enzyme-2 (ACE2) receptor is a possible port of cell entry. ACE2 is part of the renin-angiotensin system and is also associated with lung and cardiovascular disorders and inflammation. Recent studies have confirmed that ACE2 is the port of entry for SARS-CoV-2. Male sex, advanced age and a number of associated comorbidities have been identified as risk factors for infection with COVID-19. Many high-risk COVID-19 patients with comorbidities are on ACE inhibitors and angiotensin receptor blockers, and this has sparked debate about whether to continue these treatment regimes. Attention has also shifted to ACE2 being a target for future therapies or vaccines against COVID-19. In this review, we discuss COVID-19 and its complex relationship with ACE2.

Highly predictive regression model of active cases of COVID-19 in a population by screening wastewater viral load

“…The collection of smoothed daily curves has been analyzed and the deepest curve 59 among every time period a-d has been computed. (10,669) and June 1 st (11,308) gives estimated ratios of 5.316 and 5.254 in these two periods, with an average of around 5.29. This conversion factor was used to backcast the series of real active cases based on the estimated daily official COVID-19 cases in the metropolitan area of A Coruña.…”

“…SARS-CoV-2 is an enveloped virus with a nucleocapsid made up of single-stranded RNA bound to protein N (Nucleocapsid), surrounded by a lipid membrane that contains structural proteins M (Membrane), E (Envelop) and S (Spike) [5][6][7][8] . The structure of protein S gives the virus its distinctive crown of spikes and is responsible for binding to the angiotensin-converting enzyme 2 (ACE2) receptor, which allows the virus to enter the host cell 9,10 . ACE2 receptors are present in a range of human cell types, with particular abundance in respiratory and gastrointestinal epithelial cells.…”

Immunotherapy of COVID-19 with poly (ADP-ribose) polymerase inhibitors: starting with nicotinamide

“…Inhibition of angiotensin-converting enzyme, ACE 2, has also been suggested. Whereas recent discussions have centred on potential sensitivity of ACE 2 inhibitor-treated patients to COVID-19 [ 76 ], clinical trials of ACE 2 antibodies have been suggested [ 77 ].…”

Highly predictive regression model of active cases of COVID-19 in a population by screening wastewater viral load

“…SARS-CoV-2 is an enveloped virus with a nucleocapsid made up of single-stranded RNA bound to protein N (Nucleocapsid), surrounded by a lipid membrane that contains structural proteins M (Membrane), E (Envelop) and S (Spike) [5][6][7][8] . The structure of protein S gives the virus its distinctive crown of spikes and is responsible for binding to the angiotensin-converting enzyme 2 (ACE2) receptor, which allows the virus to enter the host cell 9,10 . ACE2 receptors are present in a range of human cell types, with particular abundance in respiratory and gastrointestinal epithelial cells.…”