Involvement of Spike Protein, Furin, and ACE2 in SARS-CoV-2-Related Cardiovascular Complications

Abstract

The novel coronavirus disease 2019 (COVID-19) is a global epidemic caused by severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2). SARS-CoV-2 has a similar structure to severe acute respiratory syndrome coronavirus-1(SARS-CoV-1). The S protein on the surface of the virus is cleaved by host proprotein convertases (PCs) to expose the active N-terminal S1 extracellular domain. Its receptors are angiotensin-converting enzyme 2 (ACE2), and the C-terminal S2 membrane anchoring protein is responsible for translocating the virus into the cell. Among patients with COVID-19, there is a higher prevalence of cardiovascular disease, and more than 7% of patients have suffered myocardial damage due to the infection, but the internal mechanism is still poorly understood. There is currently no specific and effective targeted treatment. Reduction of the patient's morbidity and mortality is an urgent problem that needs to be solved clinically. By exploring the theoretical analysis of PCs and ACE2 in COVID-19 cardiovascular susceptibility, some insights on how to prevent and alleviate adverse cardiovascular prognosis have been provided in this study.

Pleural empyema associated with alveolar‐pleural fistulas in severe acute respiratory syndrome coronavirus 2

“…Histologically, the SARS-CoV-2 infection associated with an acute respiratory distress syndrome (ARDS) is characterized by the vascular and respiratory epithelium damages. The angiotensin-converting enzyme-2 (ACE2) receptors, also widely expressed in the endothelial cells, allow the virus to determine a widespread endotheliitis, 1,4 with hyperplasia and subsequent thrombosis. Ackermann et al 12 described the same lesions affecting lungs, kidneys, heart, and liver in the autopsy of patients who died from COVID-19.…”

COVID-19 molecular level laboratory diagnoses

“…Membrane (M), envelope (E), spike (S), and nucleocapsid (N) proteins can be mentioned (46-48). S protein appears to be the most convenient for an immunoassay because it is a unique protein responsible for virus interaction with angiotensin-converting enzyme receptor on host cells (49)(50)(51)(52). The studies on surface antigenic structures are necessary not only for analytical respective diagnostical purposes, but also for the identifi cation of structures that would serve for development of a vaccine (53)(54)(55)(56).…”

Emerging Neurological and Psychobiological Aspects of COVID-19 Infection

“…In contrast to its predecessor SARS-CoV that also recognizes the ACE2 as its receptor [ 12 ], the entry of SARS-CoV-2 to the host cell is further facilitated by another protein called furin that cracks the virus open and allows its genetic material to pour into the host cell. In return, the additional proteins required by the original SARS virus—pangolins—are only present in lung tissue which justifies their limitation to the respiratory system [ 13 ].…”