The ACE2 enzyme may help explain why men are more vulnerable to the Covid-19 virus than women, Dutch researchers report today.
The study also found that patients taking ace-inhibitors and other related drugs did not suffer this vulnerability, according to a report in the European Heart Journal.
The study is the latest to examine the links between viral infection and various cardiovascular disease factors.
Researchers at the University Medical Centre, Groningen, studied in total more than 3,700 heart failure patients in 11 European countries.
They sought to analyse factors linked to increased rates of ACE2 – angiotensin converting enzyme 2 – and found that male gender was the strongest predictive factor.
The researchers say ACE2 is important because it helps Covid-19 to infect healthy cells.
According to the analysis, not just ACE inhibitors but angiotensin receptor blockers and renin-angiotensin-aldosterone system drugs were associated with normal blood levels of ACE2.
Researcher Professor Adrian Voors said: “Our findings do not support the discontinuation of these drugs in COVID-19 patients as has been suggested by earlier reports.
“ACE2 is a receptor on the surface of cells. It binds to the coronavirus and allows it to enter and infect healthy cells after it has been modified by another protein on the surface of the cell, called TMPRSS2. High levels of ACE2 are present in the lungs and, therefore, it is thought to play a crucial role in the progression of lung disorders related to COVID-19.”
Writing in the journal, Professor Marc Pfeffer, from Brigham and Women’s Hospital, Harvard Medical School, USA, and Professor Gavin Oudit, from the University of Alberta, Canada, write: "This field is moving so rapidly that we now have two observational studies of ARB/ACE inhibitor use in hospitalised Covid-19 patients showing no augmented risk to Covid-19 patients and even suggesting possible benefit.”
* A triple combination of anti-viral drugs is showing early promise in treating the disease, according to a report in The Lancet.
Doctors in Hong Kong set up a randomised trial involving 127 patients to test interferon beta-1b, lopinavir-ritonavir and ribavirin. They found it shorted the duration of viral shedding from 12 days to seven days in comparison with lopinavir-ritonavir.
Professor Kwok-Yung Yuen, from the University of Hong Kong, said: "Our trial demonstrates that early treatment of mild to moderate COVID-19 with a triple combination of antiviral drugs may rapidly suppress the amount of virus in a patient’s body, relieve symptoms, and reduce the risk to health-care workers by reducing the duration and quantity of viral shedding (when the virus is detectable and potentially transmissible). Furthermore, the treatment combination appeared safe and well tolerated by patients."
Circulating plasma concentrations of angiotensin-converting enzyme 2 in men and women with heart failure and effects of renin-angiotensin-aldosterone inhibitors. European Heart Journal 11 May 2020; doi:10.1093/eurheartj/ehaa373
https://academic.oup.com/eurheartj/article-lookup/doi/10.1093/eurheartj/ehaa373
Lancet 8 May 2020
http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(20)31042-4/fulltext
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