Background: A number of studies on the mechanisms of the positive effect of angiotensin (Ang) converting enzyme type 2 (ACE2) on the general condition of patients with coronavirus disease (COVID-19) reflect its direct correlation with the ACE2 concentration. This study investigated how the high-altitude factor affects angiotensin regulatory systems in patients with COVID-19 in susceptible populations.
Materials and Methods:A prospective cohort study of 335 patients with COVID-19 and concomitant arterial hypertension determined general clinical, immunological, and other parameters of health status. Group I included 135 patients of both genders with moderate COVID-19 caused by SARS-CoV-2 and moderate arterial hypertension (AH) who refused anti-hypertensive drugs. Losartan was given to 200 patients of both genders with a laboratory-confirmed mild SARS-CoV-2 infection and moderate AH in Group II.Results: Comparing Group II to Group I, the general condition parameters were found to be noticeably improved in Group II. Additionally, patients in Group II showed positive blood coagulation system dynamics. When comparing Groups I and II, the immune response was seen to be more stable in Group II.Conclusions: Group I patients with ACE2 deficiency set off a chain of events, most of which had to do with how Ang II affected the body by turning on angiotensin type 1 receptors. Observations made in Group II showed a favourable response to Ang-(1-7) and its effects on angiotensin type 2 receptors, Mas receptors, and the lowering of ACE2 bradykinin, blocking the implementation of the pro-inflammatory action through B1 receptors.