Therapeutic Approaches in COVID-19 Patients: The Role of the Renin-Angiotensin System

Table 1

The effect of recombinant ACE2 in SARS-CoV-2 infection in vitro.

Study/subject	Drugs or exposure	Time of treatment	Outcome
Extracellular vesicles (EVs) exposing cACE2	1) SARS-CoV-2	First phase :1.5 h second phase: after 24 h	(i) Effective in vesicular viral trapping
	2) TMPRSS2		(ii) More efficient: cACE2 with TMPRSS2 [43]
Vero cells (monkey), human blood vessels, and kidney organoids	1) Clinical grade of hrsACE; 2) and murine rsACE2: different concentrations	1 hour followed by washing,; or 15 h without washing	Block the cell entry of SARS-CoV-2 [41]
Vero E6 cells (monkey) and kidney organoids	1) hrsACE2 APN01 (50–800 μg/ml)	Kidney organoid: after 3 days; Liver spheroids: after 15 h; Measurement of cytotoxicity: after 24 h	Block the cell entry and replication of SARS-CoV-2 [40]
	2) Remdesivir (4–80 μM)
Renal cell line of HK2 (human) and Vero E6 cells (monkey)	1) Different concentrations of rACE2	3 days treatment	High concentration: inhibition of SARS-CoV-2 cell entry
			Physiologic concentration: increased viral cell entry [42]