Men may be more vulnerable than women to contracting the coronavirus (COVID-19) due to their having higher concentrations of the angiotensin-converting enzyme 2 (ACE2) in their blood. In a large-scale study of several thousand patients by the Netherlands' University of Groningen, researchers found that the enzyme enables the coronavirus to infect healthy cells. The study, published on Sunday in the European Heart Journal, found that heart failure patients taking drugs for the renin-angiotensin-aldosterone system (RAAS) did not have higher ACE2 concentrations in their blood. Patients were taking drugs including angiotensin-converting enzyme (ACE) inhibitors or angiotensin receptor blockers (ARBs). “Our findings do not support the discontinuation of these drugs in COVID-19 patients as has been suggested by earlier reports,” said Adriaan Voors, Professor of Cardiology at the University Medical Center Groningen, and study leader. He added, “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 is 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." Some recent research has suggested a link between the coronavirus' development in patietns and ACE2 plasma concentrations ignited by the RAAS inhibitors for cardiovascular patients taking these drugs. The current study, however, indicates that this is not the case. The study looked only at ACE2 concentrations in plasma, rather than in tissues such as those in the lungs. Researchers also cannot provide definitive evidence on the effects of RAAS inhibitors in patients with the coronavirus. This is due to the study's conclusions mainly restricted to heart failure patients who did not have the virus.
