Article ; Online: Obesity and COVID-19: the ominous duet affecting the renin-angiotensin system.
2021 Volume 46, Issue 2, Page(s) 193–201
Abstract: ... the renin-angiotensin-aldosterone system (RAAS), its receptors, and the interaction with the Kallikrein-Kinin-system (KKS) and ... between RAAS and KKS system. Our conclusion is that the higher mortality rate in patients with obesity is ... the KKS cascade may explain the frequent thromboembolic complications of COVID-19 mainly seen in obese and ...
| Abstract | The world population is facing a health challenge never seen since the Spanish influenza of one hundred years ago. During the last months, the scientific community has been debating on the potential harmful effect of angiotensin-converting-enzyme inhibitors (ACEi) or angiotensin II receptor type 1 receptor blockers (AT1-receptor blockers, ARBs) during the COVID-19 pandemic. That is because the S spike protein of SARS-CoV viruses utilizes the angiotensin-converting enzyme 2 (ACE2) as a receptor to enter alveolar epithelial cells. Obesity, often associated to type 2 Diabetes, was shown to worsen the prognosis of SARS-CoV-2 infection. Herein we discuss the complex interaction between the renin-angiotensin-aldosterone system (RAAS), its receptors, and the interaction with the Kallikrein-Kinin-system (KKS) and the potential activation of the coagulation cascade. Alteration of the equilibrium between the RAAS system and the KKS cascade may explain the frequent thromboembolic complications of COVID-19 mainly seen in obese and diabetic-obese patients. In contrast, angiotensin (1-7) contributes to maintaining a correct balance between RAAS and KKS system. Our conclusion is that the higher mortality rate in patients with obesity is linked to the alteration of RAS and RAS-KKS interaction consequent to SARS-CoV-2-cell entrance. At present, no data support the necessity of modifying ACEi or ARBs treatment in hypertensive patients. |
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| MeSH term(s) | COVID-19/complications ; COVID-19/mortality ; COVID-19/physiopathology ; Humans ; Kallikrein-Kinin System ; Obesity/complications ; Obesity/mortality ; Obesity/physiopathology ; Pandemics ; Renin-Angiotensin System | |||||
| Language | English | |||||
| Publishing date | 2021-01-12 | |||||
| Publishing country | Italy | |||||
| Document type | Journal Article ; Review | |||||
| ZDB-ID | 3062786-2 | |||||
| ISSN | 2724-6116 | |||||
| ISSN (online) | 2724-6116 | |||||
| DOI | 10.23736/S2724-6507.20.03402-1 | |||||
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| Database | MEDical Literature Analysis and Retrieval System OnLINE |
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