Musavi Hadis, Abazari Omid, Safaee Mohamad Sadegh, Variji Atena, Koohshekan Bahare, Kalaki-Jouybari Fatemeh, Barartabar Zeinab, Hakemi Pejman, Mahjoub Soleiman
Department of Clinical Biochemistry, School of Medicine, Babol University of Medical Sciences, Babol, Iran.
Department of Clinical Biochemistry, School of Medicine, Shahid Sadoughi University of Medical Sciences and Health Services, Yazd, Iran.
Iran J Allergy Asthma Immunol. 2021 Feb 11;20(1):11-23. doi: 10.18502/ijaai.v20i1.5409.
The Coronavirus disease 2019 (COVID-19) virus spread from Wuhan, China, in 2019 and is spreading rapidly around the world. COVID-19 victims are almost associated with cardiovascular disease, high blood pressure, diabetes, and other underlying diseases. Concerning the high prevalence of these disorders, widespread mortality threatens global society, and its fatality rate may increase with increasing COVID-19 prevalence in countries with older populations. Therefore, evaluating patients' clinical status with severe COVID-19 infection and their medical history can help manage treatment. Currently, one of the considered treatments is angiotensin-converting enzyme 2 (ACE2) inhibition. This study investigated virus entry mechanisms through membrane receptors, their role in the pathogenesis of COVID-19 and underlying diseases, and treatment methods based on the viral entrance inhibition. According to existing studies, inhibition of ACE2 can increase oxidative stress, inflammation, fibrosis and ultimately exacerbate underlying diseases such as cardiovascular disease, kidney disease, diabetes, and hypertension in individuals with COVID-19. The ACE2 inhibition is not suitable for patients with COVID-19 with underlying diseases, but it seems that the recombinant ACE2 solution is more appropriate for inhibiting the virus in these patients if hypotension would be monitored.
2019年冠状病毒病（COVID-19）病毒于2019年从中国武汉传播开来，目前正在全球迅速蔓延。COVID-19患者几乎都伴有心血管疾病、高血压、糖尿病和其他基础疾病。鉴于这些疾病的高患病率，广泛的死亡威胁着全球社会，而且在老年人口较多的国家，随着COVID-19患病率的增加，其死亡率可能会上升。因此，评估重症COVID-19感染患者的临床状况及其病史有助于治疗管理。目前，一种被考虑的治疗方法是抑制血管紧张素转换酶2（ACE2）。本研究调查了病毒通过膜受体的进入机制、它们在COVID-19发病机制及基础疾病中的作用，以及基于病毒进入抑制的治疗方法。根据现有研究，抑制ACE2会增加氧化应激、炎症和纤维化，最终加重COVID-19患者的心血管疾病、肾脏疾病、糖尿病和高血压等基础疾病。ACE2抑制不适用于患有基础疾病的COVID-19患者，但如果对低血压进行监测，重组ACE2溶液似乎更适合抑制这些患者体内的病毒。
