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2023, Number 1

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Rev Educ Bioquimica 2023; 42 (1)

Desequilibrio en el sistema Renina-Angiotensina-Aldosterona causado por SARS-COV-2 y sus implicaciones fisiopatológicas

Acosta-Ramos E, Hernández-López LF, Olivares-Reyes JA

Language: Spanish
References: 110
Page: 12-32
PDF size: 987.10 Kb.


ABSTRACT

Coronavirus disease (COVID-19), which is caused by the severe acute respiratory syndrome virus type 2 (SARS-CoV-2), was first detected in late 2019 in Wuhan, China, and it was declared a pandemic by the World Health Organization (WHO) in March 2020. As of September 2022, nearly 611 million confirmed cases of SARS-CoV-2 infection and about 6.5 million deaths, caused mainly by cardio/respiratory complications, had been reported in the world. The SARS-CoV-2 virus directly affects the reninangiotensin- aldosterone system (RAAS) in its classical pathway by using angiotensin-converting enzyme type 2 (ACE2) as a target site of invasion through the viral S1 protein in the lungs. The complex ACE2/SARS-CoV- 2 produces a down-regulation on the production of angiotensin 1-7 (Ang 1-7), the main contra regulatory hormone of the RAAS system. The decrease of Ang 1-7 leads to an increase in the angiotensin II/AT1 receptor (Ang II/AT1R) axis activity, which causes a systemic imbalance of RAAS to promote inflammatory signaling and the risk of cardiovascular and metabolic complications. In the present work, we will review the role of RAAS in the development of SARS-CoV-2 infection and its complications, mainly those associated with an exacerbated inflammatory response, and cardiovascular and metabolic alterations. Likewise, the main therapeutic strategies used to date to restore the balance of RAAS will be discussed.


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