Management of Hypertension in Patients with COVID-19: Implication of Angiotensin-Converting Enzyme 2

Abstract

The global coronavirus disease-19 (COVID-19) pandemic, caused by severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2), has created an unprecedented, global public health crisis. Epidemiological studies showed that hypertension is a frequent comorbidity, as well as an independent prognostic risk factor in patients with COVID-19. Angiotensin-converting enzyme-2 (ACE-2) is a receptor for SARS-CoV-2, and thus essential for viral entry into human cells. This review summarizes the recent findings of epidemiology of hypertension in COVID-19 patients and highlights the critical role of ACE2. We also review the impact of endothelial dysfunction, inflammation, and arterial stiffness in promoting hypertension and cardiovascular disease in COVID-19 patients. This review also discusses therapeutic strategies for managing hypertension in patients with COVID-19, with particular emphasis on ACE inhibitors, angiotensin receptor blockers, and calcium channel blockers.

A randomized clinical trial to evaluate the efficacy of L-carnitine L-tartrate to modulate the effects of SARS-CoV-2 infection

“…Such effects may be of particular interest concerning COVID-19 treatment ( 11 ). In addition to respiratory and metabolic dysfunction, patients with COVID-19 can experience inflammatory cytokine storms leading to organ failure ( 12 , 13 ).…”

“…In addition to respiratory and metabolic dysfunction, patients with COVID-19 can experience inflammatory cytokine storms leading to organ failure ( 12 , 13 ). These exacerbated inflammatory responses entail upregulation of the angiotensin-converting enzyme-2 (ACE2) receptor, to which the SARS-CoV-2 virus spike protein (S protein) binds, thereby gaining entry to host cells ( 11 , 13 ). This binding also relies upon transmembrane serine protease 2 (TMPRSS2) and furin peptidase, which mediate the cleavage of the spike protein at the S2’ site and S1/2 sites, respectively ( 14 , 15 ).…”

Cardiovascular Medicine in the Era of COVID-19 Pandemics

“…They also commented on therapeutic strategies for managing hypertension in COVID-19 patients, with particular focus on ACE inhibitors, angiotensin receptor blockers, and calcium channel blockers. [ 9 ] In the fifth article, Li et al . from the University of Manitoba provided insights into the complex interplay between inflammation and myocardial ischemia-reperfusion (I/R), a major cause of death.…”