Heightened ACE Activity and Unfavorable Consequences in COVID-19 Diabetic Subjects

Figure 1

Schematic diagram representing the possible effects of renin-angiotensin-adosterone-system (RAAS) inhibition on ACE expression. SARS-CoV-2 enters the host cell via the ACE 2 receptors causing downstream effects. Prior use of RAAS inhibitors is associated with the upregulation of the ACE 2, increasing viral entry into the host cell. Moreover, following viral entry, ACE 2 gets downregulated. Hypothetically, this leads to reduced ACE 2 availability for clearance of angiotensin II, resulting in acute lung injury.