Arq. Bras. Cardiol. 2020; 115(4): 701-707
ACE2 Expression and Risk Factors for COVID-19 Severity in Patients with Advanced Age
Caio de Assis Moura Tavares
, Thiago Junqueira Avelino-Silva
, Gil Benard, Francisco Akira Malta Cardozo
, Juliana Ruiz Fernandes
, Adriana Castello Costa Girardi
, Wilson Jacob Filho
ACE2, SARS-CoV-2 Infection and Aging
Abnormalities induced by aging in metabolic pathways may partly explain the higher rate of COVID-19 morbidity and mortality in elderly patients. These include those belonging to the renin-angiotensin system (RAS), given the crucial role that this system plays both in viral transmissibility and in the pathogenesis of acute lung injury and its most severe form: acute respiratory distress syndrome (ARDS).
ACE2 is known to act as a receptor for SARS-CoV-2 1 structural protein S (spike), through which the virus gains access to the host cell. This mechanism involves interaction of viral S protein with ACE2 extracellular domain, triggering conformational changes that destabilize the cell membrane, allowing the internalization of SARS-CoV-2 and ACE2, viral replication, and cell-to-cell transmission.,
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Keywords: Aging; COVID-19; Frailty; Immunosenescence; Multimorbidity
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