The expression level of angiotensin-converting enzyme 2 determines the severity of COVID-19: lung and heart tissue as targets

Mohammad Mahdi Nejadi Babadaei, Anwarul Hasan*, Samir Haj Bloukh, Zehra Edis, Majid Sharifi, Ehsan Kachooei, Mojtaba Falahati*

*Corresponding author for this work

    Research output: Contribution to journalReview articlepeer-review

    23 Citations (Scopus)


    Researchers have reported some useful information about the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) leading to CoV disease 2019 (COVID-19). Several studies have been performed in order to develop antiviral drugs, from which a few have been prescribed to patients. Also, several diagnostic tests have been designed to accelerate the process of identifying and treating COVID-19. It has been well-documented that the surface of host cells is covered by some receptors, known as angiotensin-converting enzyme 2 (ACE2), which mediates the binding and entry of CoV. After entering, the viral RNA interrupts the cell proliferation system to activate self-proliferation. However, having all the information about the outbreakof the SARS-COV-2, it is not still clear which factors determine the severity of lung and heart function impairment induced by COVID-19. A major step in exploring SARS-COV-2 pathogenesis is to determine the distribution of ACE2 in different tissues. In this review, the structure and origin of CoV, the role of ACE2 as a receptor of SARS-COV-2 on the surface of host cells, and the ACE2 distribution in different tissues with a focus on lung and cardiovascular system have been discussed. It was also revealed that acute and chronic cardiovascular diseases (CVDs) may result in the clinical severity of COVID-19. In conclusion, this review may provide useful information in developing some promising strategies to end up with a worldwide COVID-19 pandemic.

    Original languageEnglish
    Pages (from-to)3780-3786
    Number of pages7
    JournalJournal of Biomolecular Structure and Dynamics
    Issue number10
    Early online date1 Jun 2020
    Publication statusPublished - 2021


    • ACE2
    • Coronavirus
    • COVID-19
    • heart
    • lung
    • MERS
    • SARS
    • SARS-CoV-2


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