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Cytokine storm and RAAS dysregulation predispose CVD patients to severe COVID-19

Krause, Bo (2020) Cytokine storm and RAAS dysregulation predispose CVD patients to severe COVID-19. Bachelor's Thesis, Life Science and Technology.

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Abstract

The present COVID-19 pandemic is having a tremendous impact on the world, causing thousands of deaths globally. Patients with cardiovascular diseases (CVD) are considered to have an increased risk of progression to severe COVID-19 illness. A severely dysregulated immune system has been associated with disease aggravation in COVID-19. This immune system dysregulation results in a systemic hyperinflammatory state that results in acute organ injuries. Moreover, the causative virus SARS-CoV-2 causes downregulation of ACE2, which is involved in the renin-angiotensin-aldosterone-system (RAAS). ACE2 catalyzes the conversion of angiotensin II (Ang II) into Ang-(1-7) and precise balance of both systems is required for healthy regulation of essential processes (e.g. fibrosis & inflammation). Downregulation of ACE2 during SARS-CoV-2 infection results in an alteration of the Ang II/Ang-(1-7) ratio, favouring pro-inflammatory and pro-fibrotic effects of Ang II. Chronic RAAS disbalance and already existing systemic inflammation in CVD patients may predispose these patients to severe COVID-19 illness. Many CVD patients are furthermore routinely treated with RAAS inhibitors or statins, which affect ACE2 expression in tissues. Further downregulation of ACE2 upon SARS-CoV-2 infection could contribute to the RAAS dysregulation and could favour the hyperinflammatory and pro-fibrotic state in severe COVID-19.

Item Type: Thesis (Bachelor's Thesis)
Supervisor name: Huckriede, A.L.W. and Bhide, Y.C.
Degree programme: Life Science and Technology
Thesis type: Bachelor's Thesis
Language: English
Date Deposited: 04 Jun 2020 11:04
Last Modified: 04 Jun 2020 11:04
URI: https://fse.studenttheses.ub.rug.nl/id/eprint/21993

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