The Impact of <i>Angiotensin-Converting Enzyme 2</i> (<i>ACE2</i>) Expression Levels in Patients with Comorbidities on COVID-19 Severity: A Comprehensive Review
Angiotensin-Converting Enzyme 2 (ACE2) has been proved to be the main host cell receptor for the binding of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the virus responsible for the COVID-19 pandemic. The SARS-CoV-2 spike (S) protein binds to ACE2 to initiate the process of rep...
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| Format: | Article |
| Language: | English |
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MDPI AG
2021-08-01
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| Series: | Microorganisms |
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| Online Access: | https://www.mdpi.com/2076-2607/9/8/1692 |
| _version_ | 1827684641883029504 |
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| author | Rui Rodrigues Sofia Costa de Oliveira |
| author_facet | Rui Rodrigues Sofia Costa de Oliveira |
| author_sort | Rui Rodrigues |
| collection | DOAJ |
| description | Angiotensin-Converting Enzyme 2 (ACE2) has been proved to be the main host cell receptor for the binding of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the virus responsible for the COVID-19 pandemic. The SARS-CoV-2 spike (S) protein binds to ACE2 to initiate the process of replication. This enzyme is widely present in human organ tissues, such as the heart and lung. The pathophysiology of ACE2 in SARS-CoV-2 infection is complex and may be associated with several factors and conditions that are more severe in COVID-19 patients, such as age, male gender, and comorbidities, namely, cardiovascular diseases, chronic respiratory diseases, obesity, and diabetes. Here we present a comprehensive review that aims to correlate the levels of expression of the <i>ACE2</i> in patients with comorbidities and with a poor outcome in COVID-19 disease. Significantly higher levels of expression of <i>ACE2</i> were observed in myocardial and lung tissues in heart failure and COPD patients, respectively. An age-dependent increase in SARS2-CoV-2 receptors in the respiratory epithelium may be also responsible for the increased severity of COVID-19 lung disease in elderly people. Although the role of ACE2 is highlighted regarding the damage that can arise upon the SARS-CoV-2 invasion, there was no association observed between renin-angiotensin-aldosterone system (RAAS) inhibitors and the severity of COVID-19. |
| first_indexed | 2024-03-10T08:34:04Z |
| format | Article |
| id | doaj.art-4cae2e1be52e435e99c8101fe584dc23 |
| institution | Directory Open Access Journal |
| issn | 2076-2607 |
| language | English |
| last_indexed | 2024-03-10T08:34:04Z |
| publishDate | 2021-08-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Microorganisms |
| spelling | doaj.art-4cae2e1be52e435e99c8101fe584dc232023-11-22T08:47:26ZengMDPI AGMicroorganisms2076-26072021-08-0198169210.3390/microorganisms9081692The Impact of <i>Angiotensin-Converting Enzyme 2</i> (<i>ACE2</i>) Expression Levels in Patients with Comorbidities on COVID-19 Severity: A Comprehensive ReviewRui Rodrigues0Sofia Costa de Oliveira1Department of Pathology, Division of Microbiology, Faculty of Medicine, University of Porto, Al. Hernâni Monteiro, 4200-319 Porto, PortugalDepartment of Pathology, Division of Microbiology, Faculty of Medicine, University of Porto, Al. Hernâni Monteiro, 4200-319 Porto, PortugalAngiotensin-Converting Enzyme 2 (ACE2) has been proved to be the main host cell receptor for the binding of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the virus responsible for the COVID-19 pandemic. The SARS-CoV-2 spike (S) protein binds to ACE2 to initiate the process of replication. This enzyme is widely present in human organ tissues, such as the heart and lung. The pathophysiology of ACE2 in SARS-CoV-2 infection is complex and may be associated with several factors and conditions that are more severe in COVID-19 patients, such as age, male gender, and comorbidities, namely, cardiovascular diseases, chronic respiratory diseases, obesity, and diabetes. Here we present a comprehensive review that aims to correlate the levels of expression of the <i>ACE2</i> in patients with comorbidities and with a poor outcome in COVID-19 disease. Significantly higher levels of expression of <i>ACE2</i> were observed in myocardial and lung tissues in heart failure and COPD patients, respectively. An age-dependent increase in SARS2-CoV-2 receptors in the respiratory epithelium may be also responsible for the increased severity of COVID-19 lung disease in elderly people. Although the role of ACE2 is highlighted regarding the damage that can arise upon the SARS-CoV-2 invasion, there was no association observed between renin-angiotensin-aldosterone system (RAAS) inhibitors and the severity of COVID-19.https://www.mdpi.com/2076-2607/9/8/1692ACE2SARS-CoV-2COVID-19comorbidityviral receptor |
| spellingShingle | Rui Rodrigues Sofia Costa de Oliveira The Impact of <i>Angiotensin-Converting Enzyme 2</i> (<i>ACE2</i>) Expression Levels in Patients with Comorbidities on COVID-19 Severity: A Comprehensive Review Microorganisms ACE2 SARS-CoV-2 COVID-19 comorbidity viral receptor |
| title | The Impact of <i>Angiotensin-Converting Enzyme 2</i> (<i>ACE2</i>) Expression Levels in Patients with Comorbidities on COVID-19 Severity: A Comprehensive Review |
| title_full | The Impact of <i>Angiotensin-Converting Enzyme 2</i> (<i>ACE2</i>) Expression Levels in Patients with Comorbidities on COVID-19 Severity: A Comprehensive Review |
| title_fullStr | The Impact of <i>Angiotensin-Converting Enzyme 2</i> (<i>ACE2</i>) Expression Levels in Patients with Comorbidities on COVID-19 Severity: A Comprehensive Review |
| title_full_unstemmed | The Impact of <i>Angiotensin-Converting Enzyme 2</i> (<i>ACE2</i>) Expression Levels in Patients with Comorbidities on COVID-19 Severity: A Comprehensive Review |
| title_short | The Impact of <i>Angiotensin-Converting Enzyme 2</i> (<i>ACE2</i>) Expression Levels in Patients with Comorbidities on COVID-19 Severity: A Comprehensive Review |
| title_sort | impact of i angiotensin converting enzyme 2 i i ace2 i expression levels in patients with comorbidities on covid 19 severity a comprehensive review |
| topic | ACE2 SARS-CoV-2 COVID-19 comorbidity viral receptor |
| url | https://www.mdpi.com/2076-2607/9/8/1692 |
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