ReviewEBioMedicine2020
SARS-CoV-2 and ACE2: The biology and clinical data settling the ARB and ACEI controversy.
Review in EBioMedicine, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 79 papers, 2 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
79 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Risk of serious COVID-19 outcomes among adults and children with moderate-to-severe asthma: a systematic review and meta-analysis.European respiratory review : an official journal of the European Respiratory Society · 2022Pooled it
- Pooled it
- Trial
- Lessons learned: management of acute kidney injury during COVID-19.Renal failure · 2026Article
- Declining semen quality in North Africa: from 2019 to 2024: retrospective multicentric study of 21,585 patients.Reproduction & fertility · 2026Article
- 3CLJournal of computer-aided molecular design · 2025Article
- Optical Coherence Tomography (OCT) Findings in Post-COVID-19 Healthcare Workers.Journal of imaging · 2025Article
- Unveiling the Interplay-Vitamin D and ACE-2 Molecular Interactions in Mitigating Complications and Deaths from SARS-CoV-2.Biology · 2024Review
- Differential Ability of Spike Protein of SARS-CoV-2 Variants to Downregulate ACE2.International journal of molecular sciences · 2024Article
- The possible mechanism and research progress of ACE2 involved in cardiovascular injury caused by COVID-19: a review.Frontiers in cardiovascular medicine · 2024Review
- Evaluating the Role of the Renin-angiotensin System in COVID-19: Implications for ACE Inhibitor and ARB Use During SARS-CoV-2 Infection.Journal of cellular immunology · 2024Article
- The RAAS Goodfellas in Cardiovascular System.Journal of clinical medicine · 2023Review
- Review
- Article
- TCM "medicine and food homology" in the management of post-COVID disorders.Frontiers in immunology · 2023Review
- Correlation between structural heart disease and cardiac SARS-CoV-2 manifestations.Communications medicine · 2022Article
- Analysis of mechanisms of Shenhuang Granule in treating severe COVID-19 based on network pharmacology and molecular docking.Journal of integrative medicine · 2022Article
- Role of endothelial dysfunction in the severity of COVID‑19 infection (Review).Molecular medicine reports · 2022Review
- Epigenetic mechanisms and host factors impact ACE2 gene expression: Implications in COVID-19 susceptibility.Infection, genetics and evolution : journal of molecular epidemiology and evolutionary genetics in infectious diseases · 2022Article
- Review
19 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
20 authors.
Funding
Abstract
backgroundSARS-CoV-2 enters cells by binding of its spike protein to angiotensin-converting enzyme 2 (ACE2). Angiotensin-converting enzyme inhibitors (ACEIs) or angiotensin II receptor blockers (ARBs) have been reported to increase ACE2 expression in animal models, and worse outcomes are reported in patients with co-morbidities commonly treated with these agents, leading to controversy during the COVID-19 pandemic over whether these drugs might be helpful or harmful.
methodsAnimal, in vitro and clinical data relevant to the biology of the renin-angiotensin system (RAS), its interaction with the kallikrein-kinin system (KKS) and SARS-CoV-2, and clinical studies were reviewed. FINDINGS AND
interpretationSARS-CoV-2 hijacks ACE2to invade and damage cells, downregulating ACE2, reducing its protective effects and exacerbating injurious Ang II effects. However, retrospective observational studies do not show higher risk of infection with ACEI or ARB use. Nevertheless, study of the RAS and KKS in the setting of coronaviral infection may yield therapeutic targets.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.