ACE-2 receptor-associated COVID-19 lesions and sequelae

Keywords: SARS-CoV 2 Receptor, ACE-2 expression, angiotensin receptor, COVID-19


La infección por el nuevo SARS-CoV 2 se ha convertido en el mayor problema de salud pública mundial desde la aparición de la enfermedad en 2019 en China; A partir de ese momento, la comunidad médica y científica se ha enfocado en describir los mecanismos fisiopatológicos de la infección para ofrecer mejores alternativas de tratamiento a los pacientes y hacer pronósticos de la infección, sin embargo, se deben considerar las regiones anatómicas donde infecta el virus. El objetivo de esta revisión es describir los sitios de colonización del virus, los mecanismos subyacentes de lesión en órganos y sistemas, y las consecuencias provocadas por la infección. Para esta investigación se realizó una búsqueda de la literatura más reciente sobre el COVID-19 y su asociación con el receptor ACE-2.


Download data is not yet available.


Wang C, Horby PW, Hayden FG, Gao GF. A novel coronavirus outbreak of global health concern. The Lancet. 2020 Jan;395(10223):470–3

Weekly epidemiological update on COVID-19 - 25 January 2023 [Internet]. Available from:

Torrell Vallespín G, Rovira Fontanals A, Sánchez Amat M, Fernández de Sanmamed Santos MJ. Construyendo la semiología de la COVID-19: los sabios ciegos y el elefante. Gaceta Sanitaria [Internet]. 2022 Sep 1 [cited 2022 Nov 7];36(5):416–24. Available from:

Iser BPM, Sliva I, Raymundo VT, Poleto MB, Schuelter-Trevisol F, Bobinski F. Definição de caso suspeito da COVID-19: uma revisão narrativa dos sinais e sintomas mais frequentes entre os casos confirmados. Epidemiologia e Serviços de Saúde [Internet]. 2020 Jun;29(3). Available from:

Beyerstedt S, Casaro EB, Rangel ÉB. COVID-19: angiotensin-converting enzyme 2 (ACE2) expression and tissue susceptibility to SARS-CoV-2 infection. European Journal of Clinical Microbiology & Infectious Diseases. 2021 Jan 3;40(5)

Ashraf UM, Abokor AA, Edwards JM, Waigi EW, Royfman RS, Hasan SA-M, et al. SARS-CoV-2, ACE2 expression, and systemic organ invasion. Physiological Genomics. 2021 Feb 1;53(2):51–60

Jackson CB, Farzan M, Chen B, Choe H. Mechanisms of SARS-CoV-2 entry into cells. Nature Reviews Molecular Cell Biology [Internet]. 2021 Oct 5;23(1):1–18. Available from:

El SRAA y el SARS-CoV-2: el acertijo a resolver. Hipertensión y Riesgo Vascular [Internet]. 2020 Oct 1;37(4):169–75. Available from:

Li W, Moore MJ, Vasilieva N, Sui J, Wong SK, Berne MA, et al. Angiotensin-converting enzyme 2 is a functional receptor for the SARS coronavirus. Nature [Internet]. 2003 Nov;426(6965):450–4. Available from:

Jia HP, Look DC, Shi L, Hickey M, Pewe L, Netland J, et al. ACE2 Receptor Expression and Severe Acute Respiratory Syndrome Coronavirus Infection Depend on Differentiation of Human Airway Epithelia. Journal of Virology. 2005 Dec 15;79(23):14614–21

Luks AM, Freer L, Grissom CK, McIntosh SE, Schoene RB, Swenson ER, et al. COVID-19 Lung Injury is Not High Altitude Pulmonary Edema. High Altitude Medicine & Biology. 2020 Jun 1;21(2):192–3

Huang C, Wang Y, Li X, Ren L, Zhao J, Hu Y, et al. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. The Lancet. 2020 Jan 24;395(10223):497–506

Zou X, Chen K, Zou J, Han P, Hao J, Han Z. Single-cell RNA-seq data analysis on the receptor ACE2 expression reveals the potential risk of different human organs vulnerable to 2019-nCoV infection. Frontiers of Medicine. 2020 Mar 12;14(2):185–92

Qi F, Qian S, Zhang S, Zhang Z. Single cell RNA sequencing of 13 human tissues identify cell types and receptors of human coronaviruses. Biochemical and Biophysical Research Communications. 2020 May;526(1):135–40

Simões e Silva AC, Teixeira MM. ACE inhibition, ACE2 and angiotensin-(1⿿7) axis in kidney and cardiac inflammation and fibrosis. Pharmacological Research. 2016 May;107:154–62

Harmer D, Gilbert M, Borman R, Clark KL. Quantitative mRNA expression profiling of ACE 2, a novel homologue of angiotensin converting enzyme. FEBS Letters. 2002 Nov 7;532(1-2):107–10

Alibeik N, Pishgar E, Bozorgmehr R, Aghaaliakbari F, Rahimian N. Potential role of gut microbiota in patients with COVID-19, its relationship with lung axis, central nervous system (CNS) axis, and improvement with probiotic therapy. Iranian Journal of Microbiology. 2022 Feb 21

Ye Q, Wang B, Mao J. The pathogenesis and treatment of the `Cytokine Storm’ in COVID-19. Journal of Infection [Internet]. 2020 Apr;80(6). Available from:

Yang J-K, Lin S-S, Ji X-J, Guo L-M. Binding of SARS coronavirus to its receptor damages islets and causes acute diabetes. Acta Diabetologica. 2009 Mar 31;47(3):193–9

Batlle D, Jose Soler M, Ye M. ACE2 and Diabetes: ACE of ACEs? Diabetes. 2010 Nov 29;59(12):2994–6

Baig AM. Counting the neurological cost of COVID-19. Nature Reviews Neurology [Internet]. 2021 Nov 18 [cited 2021 Dec 9];1–2. Available from:

Xia H, Sriramula S, Chhabra KH, Lazartigues E. Brain Angiotensin-Converting Enzyme Type 2 Shedding Contributes to the Development of Neurogenic Hypertension. Circulation Research. 2013 Oct 12;113(9):1087–96

Davis HE, McCorkell L, Vogel JM, Topol EJ. Long COVID: major findings, mechanisms and recommendations. Nature Reviews Microbiology [Internet]. 2023 Jan 13 [cited 2023 Jan 17];1–14. Available from:

Nicin L, Abplanalp WT, Mellentin H, Kattih B, Tombor L, John D, et al. Cell type-specific expression of the putative SARS-CoV-2 receptor ACE2 in human hearts. European Heart Journal. 2020 Apr 15

Santoso A, Pranata R, Wibowo A, Al-Farabi MJ, Huang I, Antariksa B. Cardiac injury is associated with mortality and critically ill pneumonia in COVID-19: A meta-analysis. The American Journal of Emergency Medicine. 2020 Apr

Rabelo LA, Todiras M, Nunes-Souza V, Qadri F, Szijártó IA, Gollasch M, et al. Genetic Deletion of ACE2 Induces Vascular Dysfunction in C57BL/6 Mice: Role of Nitric Oxide Imbalance and Oxidative Stress. Schmidt HH, editor. PLOS ONE. 2016 Apr 12;11(4):e0150255

Xu H, Zhong L, Deng J, Peng J, Dan H, Zeng X, et al. High expression of ACE2 receptor of 2019-nCoV on the epithelial cells of oral mucosa. International Journal of Oral Science [Internet]. 2020 Feb 24;12. Available from:

Paradowska-Stolarz A. Oral manifestations of COVID-19: Brief review. Dental and Medical Problems. 2021 Feb 16;58(1):123–6

Zou X, Chen K, Zou J, Han P, Hao J, Han Z. Single-cell RNA-seq data analysis on the receptor ACE2 expression reveals the potential risk of different human organs vulnerable to 2019-nCoV infection. Frontiers of Medicine. 2020 Mar 12;14(2):185–92

Tristão LS, Bresler R, Modesto VA, Fernandes R de C, Bernardo WM. Urological complications of COVID-19: a systematic review. International Braz J Urol: Official Journal of the Brazilian Society of Urology [Internet]. 2023 [cited 2023 Feb 2];49(1):24–40. Available from:

Pastrian-Soto G, Pastrian-Soto G. Presencia y Expresión del Receptor ACE2 (Target de SARS-CoV-2) en Tejidos Humanos y Cavidad Oral. Posibles Rutas de Infección en Órganos Orales. International journal of odontostomatology [Internet]. 2020 Dec 1;14(4):501–7. Available from:

Jing Y, Run-Qian L, Hao-Ran W, Hao-Ran C, Ya-Bin L, Yang G, et al. Potential influence of COVID-19/ACE2 on the female reproductive system. Molecular Human Reproduction. 2020 May 4

Douglas GC, O’Bryan MK, Hedger MP, Lee DKL, Yarski MA, Smith AI, et al. The Novel Angiotensin-Converting Enzyme (ACE) Homolog, ACE2, Is Selectively Expressed by Adult Leydig Cells of the Testis. Endocrinology. 2004 Oct;145(10):4703–11

Wang Z, Xu X. scRNA-seq Profiling of Human Testes Reveals the Presence of the ACE2 Receptor, A Target for SARS-CoV-2 Infection in Spermatogonia, Leydig and Sertoli Cells. Cells. 2020 Apr 9;9(4):920

Xu J, Qi L, Chi X, Yang J, Wei X, Gong E, et al. Orchitis: A Complication of Severe Acute Respiratory Syndrome (SARS)1. Biology of Reproduction. 2006 Feb 1;74(2):410–6

Ryan PM, Caplice N. COVID-19 and relative angiotensin-converting enzyme 2 deficiency: role in disease severity and therapeutic response. Open Heart [Internet]. 2020 Jun 11;7(1). Available from:

Macedo S, Pestana A, Santos L, Neves C, Guimarães S, Duarte-Neto A, et al. Detection of SARS-CoV-2 infection in thyroid follicular cells from a COVID-19 autopsy series. European Thyroid Journal. 2022 Aug 1;11(4)

Salamanna F, Maglio M, Landini MP, Fini M. Body Localization of ACE-2: On the Trail of the Keyhole of SARS-CoV-2. Frontiers in Medicine. 2020 Dec 3;7

Rotondi M, Coperchini F, Ricci G, Denegri M, Croce L, Ngnitejeu ST, et al. Detection of SARS-COV-2 receptor ACE-2 mRNA in thyroid cells: a clue for COVID-19-related subacute thyroiditis. Journal of Endocrinological Investigation [Internet]. 2020 Oct 6 [cited 2020 Dec 7];1–6. Available from:

Paz-Ibarra JL. Glándula tiroides, ¿otra víctima de la COVID-19? Reporte de caso. Revista Mexicana de Endocrinología, Metabolismo y Nutrición. 2021 Aug 10;8(3)

How to Cite
Becerril Flores, M. A., Santos-Castañeda, A., Benítez-Hernández, A. K., Molina-Trinidad, E. M., & Hernández-Tapia, K. (2023). ACE-2 receptor-associated COVID-19 lesions and sequelae. Mexican Journal of Medical Research ICSA, 11(22). Retrieved from

Most read articles by the same author(s)