A new form of severe acute respiratory syndrome (SARS) caused by SARS-CoV-2, called COVID-19, has become a global threat in 2020. The mortality rate from COVID-19 is high in hypertensive patients, making this association especially dangerous. There appears to be a consensus, despite the lack of experimental data, that angiotensin II (Ang II) is linked to the pathogenesis of COVID-19. This process may occur due to acquired deficiency of angiotensin-converting enzyme 2 (ACE2), resulting in reduced degradation of Ang II. Furthermore, Ang II has a critical role in the genesis and worsening of hypertension. In this context, the idea that that there is a surge in the level of Ang II with COVID-19 infection causing multiple organ injuries in hypertensive patients becomes attractive. However, the role of other components of the renin angiotensin system (RAS) in this scenario requires elucidation. The identification of other RAS components in COVID-19 hypertension may provide both diagnostic and therapeutic benefits. Here, we summarize the pathophysiologic contributions of different components of RAS in hypertension and their possible correlation with poor outcome observed in hypertensive patients with COVID-19.

中文翻译：

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肾素-血管紧张素系统在高血压患者重症 COVID-19 发展中的作用。


由 SARS-CoV-2 引起的一种新型严重急性呼吸综合征 (SARS)，称为 COVID-19，已成为 2020 年的全球威胁。高血压患者中，COVID-19 导致的死亡率很高，因此这种关联尤其危险。尽管缺乏实验数据，但似乎已达成共识：血管紧张素 II (Ang II) 与 COVID-19 的发病机制有关。这一过程的发生可能是由于血管紧张素转换酶 2 (ACE2) 的后天性缺乏，导致 Ang II 的降解减少。此外，Ang II 在高血压的发生和恶化中起着关键作用。在这种背景下，COVID-19 感染导致 Ang II 水平激增，导致高血压患者多器官损伤的想法变得很有吸引力。然而，肾素血管紧张素系统（RAS）的其他成分在这种情况下的作用需要阐明。识别 COVID-19 高血压中的其他 RAS 成分可能会提供诊断和治疗益处。在这里，我们总结了 RAS 不同组成部分在高血压中的病理生理学作用，以及它们与在患有 COVID-19 的高血压患者中观察到的不良预后的可能相关性。