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COVID-19 and the renin-angiotensin system (RAS): A spark that sets the forest alight?
The coronavirus disease 2019 (COVID-19) pandemic has increased exponentially in numbers with more than 20 million people infected around the globe. It is clear that COVID-19 is not a simple viral pneumonia, but presents with unusual pathophysiological effects. Of special interest is that SARS-CoV-2...
Autores principales: | , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Elsevier Ltd.
2020
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7468676/ https://www.ncbi.nlm.nih.gov/pubmed/33254538 http://dx.doi.org/10.1016/j.mehy.2020.110231 |
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author | Wiese, O.J. Allwood, B.W. Zemlin, A.E. |
author_facet | Wiese, O.J. Allwood, B.W. Zemlin, A.E. |
author_sort | Wiese, O.J. |
collection | PubMed |
description | The coronavirus disease 2019 (COVID-19) pandemic has increased exponentially in numbers with more than 20 million people infected around the globe. It is clear that COVID-19 is not a simple viral pneumonia, but presents with unusual pathophysiological effects. Of special interest is that SARS-CoV-2 utilises the angiotensin-converting enzyme-2 (ACE2) for cell entry and therefore has a direct effect on the renin angiotensin system (RAS). The RAS is primarily responsible for blood pressure control via the classic pathway. Recently numerous other pathological processes have been described due to stimulation of this classic pathway. There is also a protective RAS pathway medicated by ACE2 which may be suppressed in COVID-19. This leads to overstimulation of the classic pathway with adverse cardiovascular and respiratory effects, hypercoagulation, endothelial dysfunction, inflammation and insulin resistance. We hypothesize that overreaction of the renin-angiotensin-aldosterone may account for the myriad of unusual biochemical and clinical abnormalities noted in patients infected with SARS-CoV-2. |
format | Online Article Text |
id | pubmed-7468676 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | Elsevier Ltd. |
record_format | MEDLINE/PubMed |
spelling | pubmed-74686762020-09-03 COVID-19 and the renin-angiotensin system (RAS): A spark that sets the forest alight? Wiese, O.J. Allwood, B.W. Zemlin, A.E. Med Hypotheses Article The coronavirus disease 2019 (COVID-19) pandemic has increased exponentially in numbers with more than 20 million people infected around the globe. It is clear that COVID-19 is not a simple viral pneumonia, but presents with unusual pathophysiological effects. Of special interest is that SARS-CoV-2 utilises the angiotensin-converting enzyme-2 (ACE2) for cell entry and therefore has a direct effect on the renin angiotensin system (RAS). The RAS is primarily responsible for blood pressure control via the classic pathway. Recently numerous other pathological processes have been described due to stimulation of this classic pathway. There is also a protective RAS pathway medicated by ACE2 which may be suppressed in COVID-19. This leads to overstimulation of the classic pathway with adverse cardiovascular and respiratory effects, hypercoagulation, endothelial dysfunction, inflammation and insulin resistance. We hypothesize that overreaction of the renin-angiotensin-aldosterone may account for the myriad of unusual biochemical and clinical abnormalities noted in patients infected with SARS-CoV-2. Elsevier Ltd. 2020-11 2020-09-03 /pmc/articles/PMC7468676/ /pubmed/33254538 http://dx.doi.org/10.1016/j.mehy.2020.110231 Text en © 2020 Elsevier Ltd. All rights reserved. Since January 2020 Elsevier has created a COVID-19 resource centre with free information in English and Mandarin on the novel coronavirus COVID-19. The COVID-19 resource centre is hosted on Elsevier Connect, the company's public news and information website. Elsevier hereby grants permission to make all its COVID-19-related research that is available on the COVID-19 resource centre - including this research content - immediately available in PubMed Central and other publicly funded repositories, such as the WHO COVID database with rights for unrestricted research re-use and analyses in any form or by any means with acknowledgement of the original source. These permissions are granted for free by Elsevier for as long as the COVID-19 resource centre remains active. |
spellingShingle | Article Wiese, O.J. Allwood, B.W. Zemlin, A.E. COVID-19 and the renin-angiotensin system (RAS): A spark that sets the forest alight? |
title | COVID-19 and the renin-angiotensin system (RAS): A spark that sets the forest alight? |
title_full | COVID-19 and the renin-angiotensin system (RAS): A spark that sets the forest alight? |
title_fullStr | COVID-19 and the renin-angiotensin system (RAS): A spark that sets the forest alight? |
title_full_unstemmed | COVID-19 and the renin-angiotensin system (RAS): A spark that sets the forest alight? |
title_short | COVID-19 and the renin-angiotensin system (RAS): A spark that sets the forest alight? |
title_sort | covid-19 and the renin-angiotensin system (ras): a spark that sets the forest alight? |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7468676/ https://www.ncbi.nlm.nih.gov/pubmed/33254538 http://dx.doi.org/10.1016/j.mehy.2020.110231 |
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