SARS-CoV-2/renin-angiotensin system: Deciphering the clues for a couple with potentially harmful effects on skeletal muscle

Andrea Gonzalez, Josué Orozco-Aguilar, OSCAR ANDRES ACHIARDI TAPIA, Felipe Simon, Claudio Cabello-Verrugio

Research output: Contribution to journalReview articlepeer-review

15 Scopus citations


Severe acute respiratory syndrome coronavirus (SARS-CoV-2) has produced significant health emergencies worldwide, resulting in the declaration by the World Health Organization of the coronavirus disease 2019 (COVID-19) pandemic. Acute respiratory syndrome seems to be the most common manifestation of COVID-19. A high proportion of patients require intensive care unit admission and mechanical ventilation (MV) to survive. It has been well established that angiotensin-converting enzyme type 2 (ACE2) is the primary cellular receptor for SARS-CoV-2. ACE2 belongs to the renin-angiotensin system (RAS), composed of several peptides, such as angiotensin II (Ang II) and angiotensin (1-7) (Ang-(1-7)). Both peptides regulate muscle mass and function. It has been described that SARS-CoV-2 infection, by direct and indirect mechanisms, affects a broad range of organ systems. In the skeletal muscle, through unbalanced RAS activity, SARS-CoV-2 could induce severe consequences such as loss of muscle mass, strength, and physical function, which will delay and interfere with the recovery process of patients with COVID-19. This article discusses the relationship between RAS, SARS-CoV-2, skeletal muscle, and the potentially harmful consequences for skeletal muscle in patients currently infected with and recovering from COVID-19.

Original languageEnglish
Article number7904
Pages (from-to)1-18
Number of pages18
JournalInternational Journal of Molecular Sciences
Issue number21
StatePublished - 1 Nov 2020
Externally publishedYes


  • COVID-19
  • ICU
  • Muscle wasting
  • SARS-CoV-2


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