Abstract
Since the onset of the coronavirus disease 2019 (COVID-19) pandemic, the possible roles of renin–angiotensin system (RAS) inhibitors in COVID-19 have been debated as favorable, harmful, or neutral. Angiotensin-converting enzyme 2 (ACE2) not only is the entry route of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection but also triggers a major mechanism of COVID-19 aggravation by promoting tissue RAS dysregulation, which induces a hyperinflammatory state in several organs, leading to lung injury, hematological alterations, and immunological dysregulation. ACE inhibitors and angiotensin II type-1 receptor blockers (ARBs) inhibit the detrimental hyperactivation of the RAS by SARS-CoV-2 and increase the expression of ACE2, which is a counter-regulator of the RAS. Several studies have investigated the beneficial profile of RAS inhibitors in COVID-19; however, this finding remains unclear. Further prospective studies are warranted to confirm the role of RAS inhibitors in COVID-19. In this review, we summarize the potential effects of RAS inhibitors that have come to light thus far and review the impact of RAS inhibitors on COVID-19.
【초록키워드】 COVID-19, coronavirus disease, SARS-CoV-2, ACE2, coronavirus, pandemic, Prospective Study, Infection, Lung injury, RAS, ACE inhibitor, receptor, inhibitor, expression, mechanism, hyperinflammatory state, ARBs, Neutral, detrimental, Trigger, dysregulation, acute respiratory syndrome, tissue, enzyme, hematological, organs, blocker, Hyperactivation, Effect, immunological, investigated, inhibit, induce, alterations, RAS inhibitor, 【제목키워드】 COVID-19, Impact, inhibitor,