PMC:7170368 / 1064-3047 JSONTXT

{"target":"https://pubannotation.org/docs/sourcedb/PMC/sourceid/7170368","sourcedb":"PMC","sourceid":"7170368","source_url":"https://www.ncbi.nlm.nih.gov/pmc/7170368","text":"Introduction\nThe COVID-19 outbreak caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) continues to endanger global health and to hamper the world economy. This outbreak started in December 2019 in Wuhan, Hubei Province. Unfortunately, currently, there is still no specific and effective treatment for COVID-19. Evidence shows that elderly people with SARS-CoV-2 infections and cardiovascular diseases, including hypertension, are at risk of developing severe cases [1]. A hypertension survey from 2012 to 2015 reported that 23.2% of Chinese people ≥18 years of age had hypertension, whereas the prevalence of hypertension was \u003e55% among citizens ≥65 years of age [2]. RAS plays an important role in regulating electrolyte balance and blood pressure and comprises two pathways: the ACE/Ang II/AT1R pathway and the ACE2/Ang (1–7)/Mas receptor pathway [3]. Under normal physiological conditions, the activity of the ACE/Ang II/AT1R axis and the ACE2/Ang (1–7)/Mas receptor axis are in a dynamic equilibrium state, maintaining the normal function of the corresponding system. Similar to SARS, SARS-CoV-2 is believed to invade the host through the cell entry receptor ACE2 [4]. SARS-CoV infections reduce ACE2 expression, resulting in an imbalance between the ACE/Ang II/AT1R axis and the ACE2/Ang (1–7)/Mas receptor axis [5]. Targeting the ACE/Ang II/AT1R axis is a novel therapeutic strategy for hypertension. ACEIs and ARAs not only inhibit the ACE/Ang II/AT1R pathway but also modulate the ACE2/Ang (1–7)/Mas receptor pathway [6]. The dysfunction of the renin-angiotensin system (RAS) has been observed in coronavirus infection disease (COVID-19) patients, but whether RAS inhibitors, such as angiotensin-converting enzyme inhibitors (ACEIs) and angiotensin II type 1 receptor blockers (ARBs), are associated with clinical outcomes remains unknown. Here, we aimed to evaluate the ability of RAS inhibitors to protect against COVID-19 in patients with 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