Background: COVID-19 has continued to generate concerns from across the globe with symptoms ranging from mild to acute ones. The disease has been linked to angiotensin-converting enzyme (ACE) 1 and 2, but ACE1 has been lowly researched.
Aim: To conduct a systematic review that explores the role of Angiotensin-Converting Enzymes ACE1 and ACE 2 in COVID-19 Infection and the clinical conditions of the patients with the disease.
Materials and Methods: the guidelines of PRISMA were used to select 40 journal articles across various databases namely PubMed, Cochrane Central Register of Controlled Trials (CENTRAL), and Embase for researches between 2019 and 2021. Various key terms were employed in the search process, such as "Covid-19," "Covid," "Corona Virus," "ACE," "Angiotensin-Converting Enzyme," “SARS-CoV-2,” “ACE1,” “ACE2,” and “angiotensin receptors.” The search terms were combined using Boolean operators “and/or” incomplete sentences affiliated with the topic in order to generate substantial results.
Results: COVID-19 pathologies/severity are affiliated with inverse proportionality of ACE1/ACE2 ratio. High ACE2 levels in adults act as the targets for COVID-19 while in children the high level of ACE2 is not associated with the disease’s severity. ACE1 contributes to cytokine production, which contributes to ARDS.
Discussion: Imbalanced ratio of ACE1/ACE2 increase COVID-19 severity. However, the findings apply to patients with hypertension, and therefore, more research would be needed for other pathologies of COVID-19.
Conclusion: Both the ACE1 and ACE2 are affiliated with COVID-19 severity. Therefore, ACE1/ACE2 activities can be used as markers to reflect the clinical conditions of COVID-19, thereby helping to manage the disease efficiently.
Inhaltsverzeichnis (Table of Contents)
- Abstract
- Introduction
- Materials and Methods
- Results
- Discussion
- Conclusion
Zielsetzung und Themenschwerpunkte (Objectives and Key Themes)
This systematic review aims to explore the roles of angiotensin-converting enzymes ACE1 and ACE2 in COVID-19 infection and their correlation with patient clinical conditions. The review analyzes existing research to understand the interplay between these enzymes and the severity of the disease.
- The role of ACE1 and ACE2 in COVID-19 pathogenesis
- The relationship between ACE1/ACE2 ratio and COVID-19 severity
- ACE1 and ACE2 as potential biomarkers for COVID-19 clinical management
- The impact of ACE1 on cytokine production and its contribution to ARDS
- The limitations of current research and the need for further investigation
Zusammenfassung der Kapitel (Chapter Summaries)
Abstract: This abstract introduces the study's background, highlighting the global health concern posed by COVID-19 and its connection to ACE1 and ACE2. It states the aim of conducting a systematic review to explore the roles of these enzymes in the disease and patient clinical conditions. The methods section is briefly mentioned, along with the key findings about the inverse proportionality between ACE1/ACE2 ratio and COVID-19 severity. The conclusion summarizes that both ACE1 and ACE2 are associated with COVID-19 severity and can potentially serve as markers for clinical management.
Introduction: The introduction establishes the context of the study by discussing COVID-19's global impact and its diverse symptoms, ranging from mild to severe. It highlights the known link between SARS-CoV-2 and ACE2 for host cell entry, placing ACE2 within the renin-angiotensin system (RAS). The introduction emphasizes the role of ACE1 and ACE2 in the RAS and their counter-regulatory relationship. It explains that while ACE2's role has been extensively studied, research on ACE1's involvement in COVID-19 is comparatively limited, underscoring the need for further investigation. This section clearly sets the stage for the systematic review by highlighting the gap in knowledge concerning ACE1 and its relevance to COVID-19.
Materials and Methods: This section details the methodology used in the systematic review, adhering to PRISMA guidelines. It describes the search process across databases like PubMed, CENTRAL, and Embase, specifying the search terms and inclusion/exclusion criteria. The method used Boolean operators for comprehensive search. The criteria focused on studies involving confirmed COVID-19 patients, studies using ACE1 and ACE2 as interventions, and outcomes relevant to COVID-19. Studies excluded include editorial letters, commentaries, opinion papers, animal studies, non-English language publications, and abstracts.
Results: The results section summarizes the key findings of the systematic review. It reveals a significant correlation between the imbalance in the ACE1/ACE2 ratio and the severity of COVID-19. High ACE2 levels are identified as targets for COVID-19 in adults, though this association with disease severity isn't as clear-cut in children. The contribution of ACE1 to cytokine production and the subsequent development of ARDS is also highlighted. This section presents concisely the crucial correlations uncovered through the research process.
Discussion: The discussion section analyzes the results, interpreting the findings of the study within the broader context of COVID-19 research. It emphasizes the inverse relationship between the ACE1/ACE2 ratio and disease severity and clarifies that the findings might be more applicable to patients with hypertension. The need for further research to explore the implications of the findings across other COVID-19 pathologies is articulated. The discussion section contextualizes the findings and highlights avenues for future research.
Schlüsselwörter (Keywords)
COVID-19, SARS-CoV-2, ACE1, ACE2, Angiotensin-Converting Enzyme, Renin-Angiotensin System (RAS), Acute Respiratory Distress Syndrome (ARDS), cytokine production, hypertension, biomarkers, systematic review.
Frequently Asked Questions: A Comprehensive Language Preview on ACE1 and ACE2 in COVID-19
What is the main focus of this systematic review?
This systematic review explores the roles of angiotensin-converting enzymes ACE1 and ACE2 in COVID-19 infection and their correlation with patient clinical conditions. It analyzes how these enzymes interact and influence the severity of the disease.
What are the key themes explored in this review?
Key themes include the role of ACE1 and ACE2 in COVID-19 pathogenesis, the relationship between the ACE1/ACE2 ratio and COVID-19 severity, their potential as biomarkers for clinical management, ACE1's impact on cytokine production and its contribution to ARDS (Acute Respiratory Distress Syndrome), and the limitations of current research.
What methodology was used in this systematic review?
The review followed PRISMA guidelines, searching databases like PubMed, CENTRAL, and Embase using specific search terms and inclusion/exclusion criteria. Boolean operators were used for a comprehensive search. The criteria focused on studies involving confirmed COVID-19 patients, studies using ACE1 and ACE2 as interventions, and relevant COVID-19 outcomes. Editorial letters, commentaries, opinion papers, animal studies, non-English publications, and abstracts were excluded.
What are the key findings of the systematic review?
The review found a significant correlation between an imbalance in the ACE1/ACE2 ratio and COVID-19 severity. High ACE2 levels were identified as targets for COVID-19 in adults, although this association with disease severity wasn't as clear in children. The study also highlighted ACE1's contribution to cytokine production and the development of ARDS.
What is the significance of the ACE1/ACE2 ratio in COVID-19?
The study reveals an inverse relationship between the ACE1/ACE2 ratio and the severity of COVID-19. This suggests that the balance between these two enzymes plays a crucial role in determining disease progression.
What is the role of ACE1 in COVID-19?
While ACE2's role in COVID-19 is well-established, this review highlights the relatively under-researched role of ACE1. The findings suggest ACE1 contributes to cytokine production, potentially leading to ARDS.
What are the limitations of the current research, and what future research is needed?
The review acknowledges limitations in current research and emphasizes the need for further investigation to explore the implications of the findings across different COVID-19 pathologies and patient populations. Further research is needed to fully understand the complex interplay between ACE1, ACE2, and COVID-19 severity.
What are the potential clinical implications of this research?
ACE1 and ACE2 are identified as potential biomarkers for COVID-19 clinical management. Understanding their roles could lead to improved diagnostic tools and treatment strategies.
What keywords are associated with this research?
Keywords include COVID-19, SARS-CoV-2, ACE1, ACE2, Angiotensin-Converting Enzyme, Renin-Angiotensin System (RAS), Acute Respiratory Distress Syndrome (ARDS), cytokine production, hypertension, biomarkers, systematic review.
Where can I find the full study?
The provided text is a comprehensive language preview, including a summary of the study's key findings and methodology. The full study would need to be accessed through the original publishing source (not provided in this preview).
- Quote paper
- Jacques Meljen (Author), 2021, The Role of Angiotensin-Converting Enzymes ACE1 and ACE2 in COVID-19 Infection, Munich, GRIN Verlag, https://www.grin.com/document/1157201
