The Renin-Angiotensin-Aldosterone System, Nitric Oxide, and Hydrogen Sulfide at the Crossroads of Hypertension and COVID-19: Racial Disparities and Outcomes

Int J Mol Sci. 2022 Nov 11;23(22):13895. doi: 10.3390/ijms232213895.

Abstract

Coronavirus disease 2019 is caused by SARS-CoV-2 and is more severe in the elderly, racial minorities, and those with comorbidities such as hypertension and diabetes. These pathologies are often controlled with medications involving the renin-angiotensin-aldosterone system (RAAS). RAAS is an endocrine system involved in maintaining blood pressure and blood volume through components of the system. SARS-CoV-2 enters the cells through ACE2, a membrane-bound protein related to RAAS. Therefore, the use of RAAS inhibitors could worsen the severity of COVID-19's symptoms, especially amongst those with pre-existing comorbidities. Although a vaccine is currently available to prevent and reduce the symptom severity of COVID-19, other options, such as nitric oxide and hydrogen sulfide, may also have utility to prevent and treat this virus.

Keywords: ACE2; COVID-19; RAAS inhibitors; SARS-CoV-2; health disparities; hydrogen sulfide; hypertension; nitric oxide; renin–angiotensin system.

Publication types

  • Review

MeSH terms

  • Aged
  • COVID-19 Drug Treatment*
  • Humans
  • Hydrogen Sulfide* / therapeutic use
  • Hypertension* / drug therapy
  • Nitric Oxide
  • Renin-Angiotensin System / physiology
  • SARS-CoV-2

Substances

  • Hydrogen Sulfide
  • Nitric Oxide