Figure 6. Pharmacological agents that target the RAS pathway and counteract effects of SARS-CoV-2 infection.
The concepts and data discussed above suggest a variety of approaches that may decrease the pathobiology of SARS-CoV2 infection resulting from the imbalance in signaling by peptides generated by ACE1 and ACE2 (Figure 6 ). Several complementary strategies might improve the clinical status and outcome of patients with COVID-19. The goal of these approaches is to restore ACE1/ACE2 balance in favor of ACE2-derived peptides. The proposed therapies, discussed below, are directed at: 1) Inhibition of ACE1; 2) Inhibition of the binding of SARS-Cov-2 to ACE2; 3) Agonism of receptors activated by ACE2-derived peptides; and 4) Inhibition of AGTR1 (ARBs) (Table 1 ).