md_a
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- Aug 31, 2015
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Patients with COVID-19 infection are at risk of acute respiratory disease syndrome (ARDS) and death. The tissue receptor for COVID-19 is ACE2, and higher levels of ACE2 can protect against ARDS. Angiotensin receptor blockers and statins upregulate ACE2. Clinical trials are needed to determine whether this drug combination might be used to treat patients with severe COVID-19 infection.
An approach to treating patients with severe COVID-19 infection might be hiding in plain sight. The tissue receptor for the virus is ACE2, which is also the receptor for the SARS coronavirus (1). Several years ago, investigators in the Netherlands and elsewhere showed that ARBs and statins upregulate the activity of ACE2 (14, 15), and higher levels of ACE2 are associated with a reduced severity of ARDS (16). Both statins and ARBs target the host response to infection, not the virus (9). They act largely (although not exclusively) on endothelial dysfunction, which is a common feature of many virus infections (17). Both drugs counter endothelial dysfunction by affecting the ACE2/angiotensin-(1–7)/Mas and angiopoietin/Tie-2 signaling axes (9).
Hiding in Plain Sight: an Approach to Treating Patients with Severe COVID-19 Infection
An approach to treating patients with severe COVID-19 infection might be hiding in plain sight. The tissue receptor for the virus is ACE2, which is also the receptor for the SARS coronavirus (1). Several years ago, investigators in the Netherlands and elsewhere showed that ARBs and statins upregulate the activity of ACE2 (14, 15), and higher levels of ACE2 are associated with a reduced severity of ARDS (16). Both statins and ARBs target the host response to infection, not the virus (9). They act largely (although not exclusively) on endothelial dysfunction, which is a common feature of many virus infections (17). Both drugs counter endothelial dysfunction by affecting the ACE2/angiotensin-(1–7)/Mas and angiopoietin/Tie-2 signaling axes (9).
Hiding in Plain Sight: an Approach to Treating Patients with Severe COVID-19 Infection