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World J Clin Cases. Dec 6, 2022; 10(34): 12470-12483
Published online Dec 6, 2022. doi: 10.12998/wjcc.v10.i34.12470
Circulating angiotensin converting enzyme 2 and COVID-19
Wattana Leowattana, Tawithep Leowattana, Pathomthep Leowattana
Wattana Leowattana, Pathomthep Leowattana, Department of Clinical Tropical Medicine, Faculty of Tropical Medicine, Mahidol University, Bangkok 10400, Bangkok, Thailand
Tawithep Leowattana, Department of Medicine, Faculty of Medicine, Srinakharinwirot University, Bangkok 10110, Bangkok, Thailand
Author contributions: Leowattana W wrote the paper; Leowattana T and Leowattana P collected the data.
Conflict-of-interest statement: All the author declares no conflict of interest for this article.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Wattana Leowattana, MD, MSc, PhD, Professor, Department of Clinical Tropical Medicine, Faculty of Tropical Medicine, Mahidol University, 420/6 Rajavithi Road, Rachatawee, Bangkok 10400, Bangkok, Thailand. wattana.leo@mahidol.ac.th
Received: August 4, 2022
Peer-review started: August 4, 2022
First decision: October 12, 2022
Revised: October 20, 2022
Accepted: November 8, 2022
Article in press: November 8, 2022
Published online: December 6, 2022
Core Tip

Core Tip: Recently, conflicting results on circulating ACE2 (cACE2) levels in coronavirus disease 2019 (COVID-19) patients vs healthy people with low cACE2 values were published. cACE2 levels and activity were shown to be increased in severe COVID-19 patients. However, others showed no change or decreased cACE2 in severe COVID-19 patients compared to pre-pandemic controls. Furthermore, it is unclear how SARS-CoV-2 infection and recovery impact the cACE2 level. cACE2 levels increased throughout the first 2 wk of the acute phase of COVID-19. cACE2 levels, on the other hand, were elevated for 1-3 mo after infection and decreased by 4 mo of the illness course. The purpose of this review is to look at the relationship between SARS-CoV-2 and cACE2. A variety of prospective therapeutic options for inhibiting SARS-CoV-2 infection is also explored.