Autoimmunity Reviews Volume 19, Issue 6, June 2020, 10253620 May 2020 10:16
On the other hand, therapies to boost ACE2 activity or the lung regenerative capacity could be particularly promising for the treatment of COVID-19 [44], as previously described for SARS [45].
In young individuals, higher levels of ACE2 [39] and ACE2+ cells, higher regenerative capacity and a strong immune response lead to an effective viral clearance with little or no symptoms.
In older subjects, possibly with lower ACE2 levels, or in the presence of comorbidities that can affect the angiotensin system, such as hypertension [40], or impair the immune response, such as diabetes, the slower viral clearance and sustained damage to ACE2+ AT2 cells goes beyond the reparative capacity [41], causing lung inflammation, with a high risk of precipitating into ARDS because of an uncontrolled inflammatory response. This is particularly true during seroconversion, at around 7 to 14 days from the start of viral replication
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