The angiotensin 2 converting enzyme (ACE2) is found in the heart, kidneys and other organs. In COVID-19, the respiratory disease caused by the new coronavirus, it is believed to play a role in the progression of infection in the lungs.
The study, published in the European Heart Journal, also found that widely prescribed drugs called ACE inhibitors or angiotensin receptor blockers (ARBs) do not lead to higher ACE2 concentrations and do not therefore should not increase the risk of COVID-19 for people taking it.
ACE inhibitors and ARBs are widely prescribed to patients with congestive heart failure, diabetes or kidney disease. Drugs account for billions of dollars in prescription sales worldwide.
“Our results do not support stopping these drugs in COVID-19 patients,” said Adriaan Voors, professor of cardiology at the University Medical Center (UMC) Groningen in the Netherlands, who co-led the study.
The COVID-19 pandemic has infected more than 4 million people worldwide and killed nearly 277,000 people, according to a Reuters count. Deaths and infections indicate that men are more likely than women to contract the disease and suffer serious or critical complications if they do.
Analyzing thousands of men and women, the Voors team measured the concentrations of ACE2 in blood samples taken from more than 3,500 patients with heart failure from 11 European countries.
The study began before the coronavirus pandemic, the researchers said, and therefore did not include patients with COVID-19.
But when other research began to show that ACE2 was the key to how the new coronavirus enters cells, Voors and his team found significant overlap with their study.
“When we found that one of the most powerful biomarkers, ACE2, was much higher in men than in women, I realized that this could explain why men were more likely to die from COVID-19 than women, “said Iziah Sama, a doctor from UMC Groningen who co-chaired the study.
ACE2 is a cell surface receptor that binds to the new coronavirus and allows it to enter and infect cells.
Sama and Voors noted that, just like in the lungs, ACE2 is found in the heart, kidneys, tissues lining blood vessels and at particularly high levels in the testes.
They said its presence in the testes may partially explain higher concentrations of ACE2 in men, and why men are more vulnerable to COVID-19.
Report by Kate Kelland; Editing by Catherine Evans
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