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Infect Genet Evol . Understanding on the possible routes for SARS CoV-2 invasion via ACE2 in the host linked with multiple organs damage

tetano

Editor, Senior Moderator
Infect Genet Evol


. 2022 Feb 22;99:105254.
doi: 10.1016/j.meegid.2022.105254. Online ahead of print.
Understanding on the possible routes for SARS CoV-2 invasion via ACE2 in the host linked with multiple organs damage


Nikhil Kirtipal[SUP] 1 [/SUP], Sanjay Kumar[SUP] 2 [/SUP], Sumit Kumar Dubey[SUP] 3 [/SUP], Vivek Dhar Dwivedi[SUP] 4 [/SUP], K Gireesh Babu[SUP] 5 [/SUP], Petr Malý[SUP] 6 [/SUP], Shiv Bharadwaj[SUP] 7 [/SUP]



Affiliations
Free PMC article

Abstract

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), accountable for causing the coronavirus diseases 2019 (COVID-19), is already declared as a pandemic disease globally. Like previously reported SARS-CoV strain, the novel SARS-CoV-2 also initiates the viral pathogenesis via docking viral Spike-protein with the membranal angiotensin-converting enzyme 2 (ACE2) -- a receptor on variety of cells in the human body. Therefore, COVID-19 is broadly characterized as a disease that targets multiple organs, particularly causing acute complications via organ-specific pathogenesis accompanied by destruction of ACE2[SUP]+[/SUP] cells, including alveolus, cardiac microvasculature, endothelium, and glomerulus. Under such circumstances, the high expression of ACE2 in predisposing individuals associated with anomalous production of the renin-angiotensin system (RAS) may promote enhanced viral load in COVID-19, which comparatively triggers excessive apoptosis. Furthermore, multi-organ injuries were found linked to altered ACE2 expression and inequality between the ACE2/angiotensin-(1-7)/mitochondrial Ang system (MAS) and renin-angiotensin-system (RAS) in COVID-19 patients. However, the exact pathogenesis of multi-organ damage in COVID-19 is still obscure, but several perspectives have been postulated, involving altered ACE2 expression linked with direct/indirect damages by the virus-induced immune response, such as cytokinin storm. Thus, insights into the invasion of a virus with respect to ACE2 expression site can be helpful to simulate or understand the possible complications in the targeted organ during viral infection. Hence, this review summarizes the multiple organs invasion by SARS CoV-2 linked with ACE2 expression and their consequences, which can be helpful in the management of the COVID-19 pathogenesis under life-threatening conditions.

Keywords: Angiotensin-(1-7); COVID-19; Extrapulmonary manifestation; Multiorgan damage; Pneumonia; SARS-CoV-2.
 
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