Published time: 08 April 2020
Authors: Luis Miguel Álvarez-Aragón, Antonio Luis Cuesta-Muñoz, Inmaculada Álvarez-López
Keywords: coronavirus, COVID-19
We have read with great interest the elegant manuscript by Hanff et al proposing a very interesting association between the classical renin-angiotensin system (RAS) and angiotensin-converting enzyme 2 (ACE2) dysregulation present in cardiovascular disease (CVD) and the high mortality index in patients with CVD and coronavirus disease 2019 (COVID-19). The authors state that pharmacological inhibition of classical RAS could have two simultaneous and incompatible outcomes. On the one hand, it will decrease the proinflammatory effect of Angiotensin II with its subsequent benefit on decreasing the risk of acute respiratory distress syndrome (ARDS) observed in these patients, and on the other hand, it will increase ACE2 expression and therefore the virulence of SARS-Cov2.
Inquiring into Benefits of Independent Activation of Non-Classical Renin-Angiotensin System in the Clinical Prognosis and Reduction of COVID-19 mortality