Renin-angiotensin system in the pathogenesis of COVID-19 and possible
drug targets
Abstract
COVID-19 is characterized by fever, cough, shortness of breath, myalgia,
and headache. The disease also takes a more severe form with
life-threatening manifestations of acute respiratory distress syndrome
(ARDS), acute cardiac injury, acute kidney injury, disseminated
intravascular coagulopathy, and cytokine storm. It has been elucidated
that like its predecessor, the SARS CoV, the SARS CoV-2 utilizes the
ACE2 receptor to enter cells. This knowledge brought into speculation
the effects of a dysregulated Renin-Angiotensin system (RAS) in the
pathogenesis of COVID-19. It has been proposed that the effects of a
dysregulated RAS would lead to an inflammatory cascade and contribute to
the cytokine storm that is central to the disease. This paper looks at
the RAS pathway and the hypothesizes the possibility of a positive RAS
feedback loop in the pathogenesis of COVID-19. We also propose possible
drug targets for the treatment of COVID-19.