Highlights The Angiotensin system has been implicated in the pathogenesis of COVID-19. Functional ACE / ACE2 polymorphisms might contribute to the outcome of COVID-19. Severe COVID-19 was associated with hypertension, male gender, and ACE-DD genotype. The ACE2 polymorphism was not associated with the disease outcome. ACE2 showed no coding variants that could explain an increased risk of COVID-19.

These results prove the existence of a pathogenic mechanism of lung stretch-induced hippocampal apoptosis that could explain the neurological changes in ventilated patients and may help to identify novel therapeutic approaches.