scholarly journals COVID-19 and Cardiovascular Disease

Circulation ◽  
2020 ◽  
Vol 141 (20) ◽  
pp. 1648-1655 ◽  
Author(s):  
Kevin J. Clerkin ◽  
Justin A. Fried ◽  
Jayant Raikhelkar ◽  
Gabriel Sayer ◽  
Jan M. Griffin ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Angiotensin Converting Enzyme ◽  
Enzyme Inhibitors ◽  
Angiotensin Receptor Blockers ◽  
Angiotensin Converting Enzyme Inhibitors ◽  
Converting Enzyme ◽  
Converting Enzyme Inhibitors ◽  
Angiotensin Converting Enzyme 2 ◽  
Global Pandemic ◽  
Receptor Blockers

Coronavirus disease 2019 (COVID-19) is a global pandemic affecting 185 countries and >3 000 000 patients worldwide as of April 28, 2020. COVID-19 is caused by severe acute respiratory syndrome coronavirus 2, which invades cells through the angiotensin-converting enzyme 2 receptor. Among patients with COVID-19, there is a high prevalence of cardiovascular disease, and >7% of patients experience myocardial injury from the infection (22% of critically ill patients). Although angiotensin-converting enzyme 2 serves as the portal for infection, the role of angiotensin-converting enzyme inhibitors or angiotensin receptor blockers requires further investigation. COVID-19 poses a challenge for heart transplantation, affecting donor selection, immunosuppression, and posttransplant management. There are a number of promising therapies under active investigation to treat and prevent COVID-19.

scholarly journals Angiotensin-Converting Enzyme Inhibitor / Angiotensin II Receptor Blocker in COVID-19: a Double-edged Sword or a Myth

2020 ◽  
Vol 3 (1) ◽  
pp. 309-312
Author(s):  
Kunal Bikram Shaha ◽  
Ashok Adhikari ◽  
Jung Rae Cho ◽  
Bimal Pandey ◽  
Yubaraj Sharma ◽  
...  
Keyword(s):  
Severe Acute Respiratory Syndrome ◽  
Angiotensin Converting Enzyme ◽  
Enzyme Inhibitors ◽  
Angiotensin Receptor Blockers ◽  
Angiotensin Converting Enzyme Inhibitors ◽  
Converting Enzyme ◽  
Angiotensin Receptor ◽  
Converting Enzyme Inhibitors ◽  
Angiotensin Converting Enzyme 2 ◽  
Receptor Blockers

Angiotensin-converting enzyme-2 receptor has been unearthed as a prime site of entry of Severe Acute Respiratory Syndrome Coronavirus 2 owing to its strong affinity towards spike protein of Severe Acute Respiratory Syndrome Coronavirus 2, resulting in down-regulation of Angiotensin-converting enzyme -2 receptors and hyperstimulation of Angiotensin-converting enzyme-1 pathway. This proposed theory has led to the birth of a new controversy regarding the use of Angiotensin-converting enzyme inhibitors/angiotensin receptor blockers in Coronavirus disease 2019 patients. A theory is against the use of Angiotensin-converting enzyme inhibitors/angiotensin receptor blockers, as it enhances the effect of Angiotensin-converting enzyme -2 pathway and upregulation of Angiotensin-converting enzyme -2 receptors resulting in a large number of internalizations of Severe Acute Respiratory Syndrome Coronavirus -2 into cells culminating into a high load of viremia with overwhelming infection and severity. The other theory considers Angiotensin-converting enzyme inhibitors / Angiotensin receptor blockers useful as it blocks deleterious Angiotensin-converting enzyme -1 pathway triggered by Severe Acute Respiratory Syndrome Coronavirus 2 and enhances Angiotensin-converting enzyme -2 receptor upregulation and activation of angiotensin-(1-7) leading to beneficial effects, i.e vasodilation, anti-apoptosis, anti-proliferative, & antifibrosis. Hence, Angiotensin-converting enzyme inhibitors/angiotensin receptor blockers may prove beneficial in countering the Angiotensin-converting enzyme -1 mediated damage by Severe Acute Respiratory Syndrome Coronavirus 2. The recommendations by (European & American) societal guidelines still hold good of not discontinuing Angiotensin-converting enzyme inhibitors/angiotensin receptor blockers in COVID-19 patients as it is further supported by current evidence of large observational studies.  

scholarly journals Effects of Angiotensin-Converting Enzyme Inhibitors and Angiotensin Receptor Blockers on Angiotensin-Converting Enzyme 2 Levels: A Comprehensive Analysis Based on Animal Studies

2021 ◽  
Vol 12 ◽  
Author(s):  
Gábor Kriszta ◽  
Zsófia Kriszta ◽  
Szilárd Váncsa ◽  
Péter Jenő Hegyi ◽  
Levente Frim ◽  
...  
Keyword(s):  
Angiotensin Converting Enzyme ◽  
Animal Studies ◽  
Enzyme Inhibitors ◽  
Angiotensin Receptor Blockers ◽  
Angiotensin Converting Enzyme Inhibitors ◽  
Experimental Models ◽  
Converting Enzyme ◽  
Converting Enzyme Inhibitors ◽  
Angiotensin Converting Enzyme 2 ◽  
Receptor Blockers

Severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2), the pathogen of coronavirus disease 2019 (COVID‐19), caused the outbreak escalated to pandemic. Reports suggested that near 1–3% of COVID‐19 cases have a fatal outcome. Angiotensin-converting enzyme inhibitors (ACEIs) and angiotensin receptor blockers (ARBs) are widely used in hypertension, heart failure and chronic kidney disease. These drugs have been reported to upregulate angiotensin converting enzyme 2 (ACE2) which produces Ang (1–7), the main counter-regulatory mediator of angiotensin II. This enzyme is also known as the receptor of SARS‐CoV‐2 promoting the cellular uptake of the virus in the airways, however, ACE2 itself proved to be protective in several experimental models of lung injury. The present study aimed to systematically review the relationship between ACEI/ARB administration and ACE2 expression in experimental models. After a comprehensive search and selection, 27 animal studies investigating ACE2 expression in the context of ACEI and ARB were identified. The majority of these papers reported increased ACE2 levels in response to ACEI/ARB treatment. This result should be interpreted in the light of the dual role of ACE2 being a promoter of viral entry to cells and a protective factor against oxidative damage in the lungs.

scholarly journals Myocyte Specific Upregulation of ACE2 in Cardiovascular Disease: Implications for SARS-CoV-2 mediated myocarditis

2020 ◽  
Author(s):  
Nathan R. Tucker ◽  
Mark Chaffin ◽  
Kenneth C. Bedi ◽  
Irinna Papangeli ◽  
Amer-Denis Akkad ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Angiotensin Converting Enzyme ◽  
Enzyme Inhibitors ◽  
Angiotensin Receptor Blockers ◽  
Angiotensin Converting Enzyme Inhibitors ◽  
Host Cells ◽  
Converting Enzyme ◽  
Converting Enzyme Inhibitors ◽  
Global Pandemic ◽  
Single Nucleus

Coronavirus disease 2019 (COVID-19) is a global pandemic caused by a novel severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2). SARS-CoV-2 infection of host cells occurs predominantly via binding of the viral surface spike protein to the human angiotensin-converting enzyme 2 (ACE2) receptor.1 Hypertension and pre-existing cardiovascular disease are risk factors for morbidity from COVID-19,2 and it remains uncertain whether the use of angiotensin converting enzyme inhibitors (ACEi) or angiotensin receptor blockers (ARB) impacts infection and disease. Here, we aim to shed light on this question by assessing ACE2 expression in normal and diseased human myocardial samples profiled by bulk and single nucleus RNA-seq.

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