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Coronavirus disease 2019 (COVID-19) and the renin-angiotensin system: A closer look at angiotensin-converting enzyme 2 (ACE2).
Ann Clin Biochem. 2020 Sep; 57(5):339-350.AC

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.

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Authors+Show Affiliations

Zemlin AE
Department of Pathology, Chemical Pathology Division, National Health Laboratory Service (NHLS) and University of Stellenbosch, Tygerberg Hospital, Cape Town, South Africa.
Wiese OJ
Department of Pathology, Chemical Pathology Division, National Health Laboratory Service (NHLS) and University of Stellenbosch, Tygerberg Hospital, Cape Town, South Africa.

MeSH

Angiotensin-Converting Enzyme 2Angiotensin-Converting Enzyme InhibitorsAnimalsBetacoronavirusCOVID-19Coronavirus InfectionsHumansPandemicsPeptidyl-Dipeptidase APneumonia, ViralRenin-Angiotensin SystemSARS-CoV-2

Pub Type(s)

Journal Article
Review

Language

eng

PubMed ID

32369402

Citation

Zemlin, Annalise E., and Owen J. Wiese. "Coronavirus Disease 2019 (COVID-19) and the Renin-angiotensin System: a Closer Look at Angiotensin-converting Enzyme 2 (ACE2)." Annals of Clinical Biochemistry, vol. 57, no. 5, 2020, pp. 339-350.
Zemlin AE, Wiese OJ. Coronavirus disease 2019 (COVID-19) and the renin-angiotensin system: A closer look at angiotensin-converting enzyme 2 (ACE2). Ann Clin Biochem. 2020;57(5):339-350.
Zemlin, A. E., & Wiese, O. J. (2020). Coronavirus disease 2019 (COVID-19) and the renin-angiotensin system: A closer look at angiotensin-converting enzyme 2 (ACE2). Annals of Clinical Biochemistry, 57(5), 339-350. https://doi.org/10.1177/0004563220928361
Zemlin AE, Wiese OJ. Coronavirus Disease 2019 (COVID-19) and the Renin-angiotensin System: a Closer Look at Angiotensin-converting Enzyme 2 (ACE2). Ann Clin Biochem. 2020;57(5):339-350. PubMed PMID: 32369402.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Coronavirus disease 2019 (COVID-19) and the renin-angiotensin system: A closer look at angiotensin-converting enzyme 2 (ACE2). AU - Zemlin,Annalise E, AU - Wiese,Owen J, Y1 - 2020/06/02/ PY - 2020/5/6/pubmed PY - 2020/10/21/medline PY - 2020/5/6/entrez KW - COVID-19 KW - SARS-CoV-2 KW - angiotensin-converting enzyme 2 KW - renin-angiotensin system SP - 339 EP - 350 JF - Annals of clinical biochemistry JO - Ann Clin Biochem VL - 57 IS - 5 N2 - 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. SN - 1758-1001 UR - https://www.unboundmedicine.com/medline/citation/32369402/Coronavirus_disease_2019__COVID_19__and_the_renin_angiotensin_system:_A_closer_look_at_angiotensin_converting_enzyme_2__ACE2__ DB - PRIME DP - Unbound Medicine ER -