ACE 2 is the functional receptor that SARS-Cov-2 virus requires to enter
cells and cause dysregulated inflammatory conditions that contribute
towards acute lung injuries. The RAAS with its physiological
surveillance and regulation system can be implicated in both harm and
therapeutic benefit. The initial observational studies suggesting the
discontinuation of ACE-I and ARBs have been firmly rebutted by
international societies. On the contrary, these therapeutics may confer
a survival benefit in Covid 19 infections. Understanding the biological
plausibility of this pathway alongside the emerging therapeutic evidence
may yield new modes of treatment. Such developments appear fundamentally
important in the battle against the inevitable emergence of new variants
and their potential to drive future waves of Covid 19 pandemics.