Renin Angiotensin System and Coronavirus Disease 2019 (COVID-19): An updated review

Abstract

Abnormal Renin-Angiotensin System (RAS) activation has a pivotal role in pathogenesis of cardiovascular or metabolic diseases, known risk factors for poor outcomes in COVID-19. An additional tissue RAS imbalance trough interaction of ‘severe acute respiratory syndrome coronavirus 2’ (SARS-CoV-2) with angiotensin-converting enzyme 2 (ACE-2) seems to play a role in pathogenesis of COVID-19. This interaction has raised some questions about safety of RAS-inhibitors use in COVID-19 patients. On the other hand, potential benefits of RAS-inhibitors use have been suggested. This article presents a brief updated review of renin-angiotensin system (RAS) focusing on interaction with SARS-CoV-2 infection, potential risks or benefits of RAS-inhibitors use, and RAS-related therapeutic targets in COVID-19.