The primary causes of COVID-19 morbidity and mortality are: 1) lung injury with associated respiratory distress (and accompanying cytokine storm) and 2) heart failure or other cardiac dysfunction (Guo et al., 2020; He et al., 2020; Zhou et al., 2020a; Zhou et al., 2020b). Therapeutic strategies for COVID-19 seek to prevent/slow viral infection or mitigate injury from the infection. In view of the apparent lack of success thus far with antiviral therapies and the time needed to develop vaccines, we propose strategies that focus on blunting the pathobiology that we hypothesize results from ACEI/ACE2 imbalance and enhanced ANG II signaling that occurs with SARS-CoV-2 infection.

Figure 1. A schema identifying the tissues impacted by SARS-CoV-2 infection and COVID-19 pathobiology . Dashed arrows identify events whose role is as-yet unclear