BACKGROUND The identification of vulnerable subgroups and risk factors associated with the susceptibility to severe acute respiratory syndrome coronavirus 2 (SARS-CoV- 2) infection and coronavirus disease 2019 (COVID-19) is of utmost importance in a pandemic scenario. Potential interactions between renin-angiotensin system (RAS), immune markers and COVID-19 play a role in disease outcome in specific groups of patients. OBJECTIVE This review aimed to describe the particularities of the RAS and the immune system profile of particular subgroups of patients. METHODS This non-systematic review summarizes evidence on SARS-CoV-2 infection in specific subgroups of patients and possible relationships between immune system, RAS and the pathophysiology of COVID-19. RESULTS The RAS and the immune system exert a role in the pathogenesis and prognosis of COVID-19, mainly in cases of hypertension, diabetes, obesity and other chronic diseases. The overactivation of the ACE/Ang II/AT1R axis and the enhancement of inflammation contribute to deleterious effects of COVID-19. Likewise, pregnant women and elderly patients usually display immune responses that are less effective in withstanding exposition to viruses, while children are relatively protected against severe complications of COVID-19. Women, conversely, exhibit stronger antiviral responses and are less sensitive to the effects of increased Ang II. Future Perspectives: The recognition of vulnerable subgroups and risk factors for disease severity is essential to better understand the pandemic. Precision medicine tools, including proteomics and metabolomics approaches, identified metabolic patterns of the severe form of disease and might be the alternative to diagnose, evaluate and predict the prognosis and the efficiency of therapies.

中文翻译：

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COVID-19 特定亚组的肾素血管紧张素系统 (RAS) 和免疫系统概况。

背景 识别与严重急性呼吸综合征冠状病毒 2 (SARS-CoV-2) 感染和 2019 年冠状病毒病 (COVID-19) 易感性相关的脆弱亚组和危险因素在大流行情况下至关重要。肾素-血管紧张素系统 (RAS)、免疫标志物和 COVID-19 之间的潜在相互作用在特定患者群体的疾病结果中发挥作用。目的 本综述旨在描述 RAS 的特殊性和特定患者亚组的免疫系统特征。方法 本次非系统性综述总结了特定患者亚组中 SARS-CoV-2 感染的证据以及免疫系统、RAS 和 COVID-19 病理生理学之间的可能关系。结果 RAS 和免疫系统在 COVID-19 的发病机制和预后中发挥作用，主要发生在高血压、糖尿病、肥胖和其他慢性疾病的病例中。ACE/Ang II/AT1R 轴的过度激活和炎症的增强导致 COVID-19 的有害影响。同样，孕妇和老年患者通常表现出的免疫反应在抵抗暴露于病毒方面效果较差，而儿童则相对免受 COVID-19 严重并发症的影响。相反，女性表现出更强的抗病毒反应，并且对 Ang II 增加的影响不太敏感。未来展望：识别易受伤害的亚群和疾病严重程度的风险因素对于更好地了解大流行至关重要。精准医疗工具，