RAS up-regulation is associated with lung and cardiovascular injuries in COVID-19.
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Apelin can suppress ACE and AT1R, and activate ACE2 which is down-regulated by SARS-CoV-2.
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Apelin may improve Ang-II-mediated inflammation, thrombosis, and vasoconstriction in COVID-19.
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Apelin and its receptor agonists could be trialed in COVID-19 patients.
Abstract
We believe that, in parallel to the attempts for direct blockade of the SARS-CoV-2 penetration into host cell and repurposing drugs, finding new therapeutic strategies for patients with lung injury or cardiovascular complications/coagulopathies associated with COVID-19 should be paid particular attention. Apelin or its receptor agonists are of great potential treatment for COVID-19 through suppressing angiotensin-converting enzyme (ACE) and angiotensin II (Ang-II) production, as well as, down-regulating angiotensin receptor 1 (AT1R) and ACE2 up-regulation. These drugs have potential to improve acute lung injury and cardiovascular/coagulopathy complications in COVID-19 which are associated with elevated Ang-II/Ang(1–7) ratio.