The Impact of Angiotensin-Converting Enzyme 2 Expression Levels in Patients with Comorbidities on COVID-19 Severity: A Comprehensive Review

The review examined the role of ACE2 expression levels in COVID-19 severity among patients with comorbidities. It found that higher ACE2 expression in conditions like cardiovascular disease, COPD, diabetes, and obesity was linked to more severe COVID-19 outcomes. Factors such as age, male gender, smoking, and obesity were associated with increased ACE2 expression, potentially heightening susceptibility to severe infection. The review also noted that asthma patients had lower ACE2 expression, correlating with reduced severity. Despite ACE2's role in SARS-CoV-2 infection, the use of RAAS inhibitors was not linked to increased COVID-19 severity. The study emphasized the need for further research to understand ACE2's role in COVID-19 pathogenesis to inform therapeutic strategies.