İmdat EROĞLU, Oğuz Abdullah UYAROĞLU, Gülay SAİN GÜVEN

Güncel Veriler Işığında COVID-19 ve Renin Anjiyotensin Aldosteron Sistemi İlişkisi

Aralık 2019’da Çin’de etiyolojisi bilinmeyen pnömoni vakaları bildirmiş olup daha önce insanlarda tespit edilmemiş yeni bir coronavirus’un hastalığa neden olduğu tespit edilmiştir. 2002 yılında salgın yapan SARS-CoV virusuna olan benzerliğinden dolayı SARS-CoV-2 olarak adlandırılmış, virusun yol açtığı klinik hastalığa da Coronavirus Hastalığı-2019 (Coronavirus Disease – 2019, COVID-19) adı verilmiştir. Hastalığın patofizyolojisi üzerine yapılan ilk çalışmalarda SARS-CoV-2’nin hücreye giriş reseptörü olarak Anjiyotensin Dönüştürücü Enzim2 (ACE2)’yi kullandığı saptanmıştır. Hastalığın Renin Anjiyotensin Aldosteron Sistemi (RAAS) blokerlerinin sıklıkla kullanıldığı hasta gruplarında (hipertansiyon, kardiyovasküler hastalıklar) daha sık ve ağır seyrettiğinin görülmesi RAAS blokeri olarak kullanılan Anjiyotensin Dönüştürücü Enzim (ACE) İnhibitörleri ve Anjiyotensin Reseptör Blokörlerinin (ARB) kullanımı ile ilgili endişelere yol açmıştır. COVID-19 pandemisinin başından itibaren bilim dünyasında bu konu ile ilgili bir çok farklı görüşler bildirilmiş, çalışmalar yapılmış ve yapılmaya devam etmektedir. Bu yazıda, COVID-19 ve RAAS arasındaki ilişki ve COVID-19 hastalarında ACEI/ARB kullanımının potansiyel etkileri güncel literatür eşliğinde gözden geçirilmiştir.

Anahtar Kelimeler:

COVID-19, Anjiyotensin Dönüştürücü Enzim, ACE, Renin Anjiyotensin Aldosteron Sistemi, RAAS

The Relation Between COVID-19 and Renin Angiotensin Aldosterone System in the Light of Current Literature

In December 2019, pneumonia cases of unknown etiology reported in China. A new coronavirus not previously detected in humans has been found to cause disease. The virus was named SARS-CoV-2 because of the similarity to the epidemic SARS-CoV virus in 2002. The clinical disease caused by the virus was called coronavirus disease-2019 (coronavirus disease - 2019, COVID-19). In the first studies on the pathophysiology of the disease, it was found that SARS-CoV-2 used Angiotensin-Converting Enzyme 2 (ACE2) as the cell entry receptor. The disease has been observed to be more frequent and severe in patient groups (hypertension, cardiovascular diseases) whom Renin Angiotensin Aldosterone System (RAAS) blockers are frequently used. This situation has led to concerns about the use of Angiotensin-Converting Enzyme Inhibitors(ACEI) and Angiotensin Receptor Blockers (ARB). Since the beginning of the COVID-19 pandemic, many different opinions about this issue have been reported. Studies have been done and continue to be carried out. In this article, the relationship between COVID-19 and RAAS and the potential effects of ACEI / ARB use in COVID-19 patients are reviewed in the light of current literature.

Keywords:

COVID-19; Angiotensin-Converting Enzyme; ACE; Renin Angiotensin Aldosterone System; RAAS,

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