Angiotensin-converting enzyme 2 (ACE2): COVID 19 gate way to multiple organ failure syndromes

• Published in: Respiratory physiology & neurobiology 2021-01, Vol.283, p.103548-103548, Article 103548
• Main Authors: loganathan, Sundareswaran, Kuppusamy, Maheshkumar, Wankhar, Wankupar, Gurugubelli, Krishna Rao, Mahadevappa, Vidyashree Hodagatta, Lepcha, Lhakit, Choudhary, Arbind kumar
• Format: Article
• Language: English
• Subjects: ACE2; Acute Kidney Injury - immunology; Acute Kidney Injury - physiopathology; Angiotensin-Converting Enzyme 2; ARDS; Arrhythmias, Cardiac - immunology; Arrhythmias, Cardiac - physiopathology; Betacoronavirus - metabolism; Coronavirus Infections - immunology; Coronavirus Infections - physiopathology; COVID-19; Cytokine Release Syndrome - immunology; Cytokine Release Syndrome - physiopathology; Cytokines - immunology; Endothelium, Vascular - metabolism; Erythrocytes - metabolism; Gastrointestinal Diseases - immunology; Gastrointestinal Diseases - physiopathology; Gastrointestinal Tract - metabolism; Heart Failure - immunology; Heart Failure - physiopathology; Humans; Inflammation - immunology; Kidney - metabolism; Liver - metabolism; Liver Diseases - immunology; Liver Diseases - physiopathology; Lung - metabolism; Multiple Organ Failure - immunology; Multiple Organ Failure - physiopathology; Myocardium - metabolism; Pandemics; Peptidyl-Dipeptidase A - metabolism; Pneumonia and inflammation; Pneumonia, Viral - immunology; Pneumonia, Viral - physiopathology; Respiratory Distress Syndrome - immunology; Respiratory Distress Syndrome - physiopathology; Review; SARS-CoV-2; Spike Glycoprotein, Coronavirus - metabolism; Thromboembolism - immunology; Thromboembolism - physiopathology; Viral Load
• ISSN: 1569-9048; 1878-1519; 1878-1519
• DOI: 10.1016/j.resp.2020.103548

•SARS-CoV-2 interfered primarily by angiotensin-converting enzyme 2 (ACE2) receptor.•Depending on the viral load, SARS-COV-2 infections spread to other major organs, mainly based on ACE2 receptor expression.•Cytokine storm and organ crosstalk result in systemic inflammation with multi-organ failure syndromes. Globally, the current medical emergency for novel coronavirus 2019 (COVID-19) leads to respiratory distress syndrome and death. This review highlighted the effect of COVID-19 on systemic multiple organ failure syndromes. This review is intended to fill a gap in information about human physiological response to COVID-19 infections. This review may shed some light on other potential mechanisms and approaches in COVID -19 infections towards systemic multiorgan failure syndromes. SARS-CoV-2 intervened mainly in the lung with progression to pneumonia and acute respiratory distress syndrome (ARDS) via the angiotensin-converting enzyme 2(ACE2) receptor. Depending on the viral load, infection spread through the ACE2 receptor further to various organs such as heart, liver, kidney, brain, endothelium, GIT, immune cell, and RBC (thromboembolism). This may be aggravated by cytokine storm with the extensive release of proinflammatory cytokines from the deregulating immune system. The widespread and vicious combinations of cytokines with organ crosstalk contribute to systemic hyper inflammation and ultimately lead to multiple organ dysfunction (Fig. 1). This comprehensive study comprises various manifestations of different organs in COVID-19 and may assist the clinicians and scientists pertaining to a broad approach to fight COVID 19.