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Renin-Angiotensin-Aldosterone System Inhibitors in Patients with Covid-19

. 2020 Apr 23;382(17):1653-1659. doi: 10.1056/NEJMsr2005760. Epub 2020 Mar 30. Renin-Angiotensin-Aldosterone System Inhibitors in Patients with Covid-19

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Renin-Angiotensin-Aldosterone System Inhibitors in Patients with Covid-19

Muthiah Vaduganathan et al. N Engl J Med. 2020.

. 2020 Apr 23;382(17):1653-1659. doi: 10.1056/NEJMsr2005760. Epub 2020 Mar 30. Affiliation

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Figure 1. Interaction between SARS-CoV-2 and the…

Figure 1. Interaction between SARS-CoV-2 and the Renin–Angiotensin–Aldosterone System.

Shown is the initial entry of…

Figure 1. Interaction between SARS-CoV-2 and the Renin–Angiotensin–Aldosterone System.

Shown is the initial entry of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) into cells, primarily type II pneumocytes, after binding to its functional receptor, angiotensin-converting enzyme 2 (ACE2). After endocytosis of the viral complex, surface ACE2 is further down-regulated, resulting in unopposed angiotensin II accumulation. Local activation of the renin–angiotensin–aldosterone system may mediate lung injury responses to viral insults. ACE denotes angiotensin-converting enzyme, and ARB angiotensin-receptor blocker.

Comment in Cited by References
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    1. Hoffmann M, Kleine-Weber H, Schroeder S, et al. SARS-CoV-2 cell entry depends on ACE2 and TMPRSS2 and is blocked by a clinically proven protease inhibitor. Cell 2020. March 4 (Epub ahead of print). - PMC - PubMed
    1. Li W, Zhang C, Sui J, et al. Receptor and viral determinants of SARS-coronavirus adaptation to human ACE2. EMBO J 2005;24:1634-1643. - PMC - PubMed
    1. Wrapp D, Wang N, Corbett KS, et al. Cryo-EM structure of the 2019-nCoV spike in the prefusion conformation. Science 2020;367:1260-1263. - PMC - PubMed
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