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SARS-CoV-2 can decrease cell surface ACE2 directly by internalization of ACE2 bound to the virus and indirectly by increased ADAM17 (a disintegrin and metalloproteinase 17)-mediated shedding of ACE2. ACE2 is widely expressed in the heart, lungs, vasculature, kidney and the gastrointestinal (GI) tract, where it counteracts the deleterious effects of angiotensin II (AngII) by catalyzing the conversion of AngII into the vasodilator peptide angiotensin-(1-7) (Ang-(1-7)). The down-regulation of ACE2 by SARS-CoV-2 can be detrimental to the cardiovascular system and kidneys. Further, decreased ACE2 can cause gut dysbiosis, inflammation and potentially worsen the systemic inflammatory response and coagulopathy associated with SARS-CoV-2. This review aims to elucidate the crucial role of ACE2 both as a regulator of the renin\u2013angiotensin system and a receptor for SARS-CoV-2 as well as the implications for Coronavirus disease 19 and its associated cardiovascular and renal complications.<\/jats:p>","DOI":"10.1042\/cs20200482","type":"journal-article","created":{"date-parts":[[2021,1,7]],"date-time":"2021-01-07T21:21:49Z","timestamp":1610054509000},"page":"1-17","update-policy":"https:\/\/doi.org\/10.1042\/crossmark_policy","source":"Crossref","is-referenced-by-count":23,"title":["Angiotensin-converting enzyme 2 and COVID-19 in cardiorenal diseases"],"prefix":"10.1042","volume":"135","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8099-0697","authenticated-orcid":false,"given":"Ravindra\u00a0K.","family":"Sharma","sequence":"first","affiliation":[{"name":"Division of Nephrology, Hypertension and Renal Transplantation, Department of Medicine, University of Florida College of Medicine, Gainesville, FL 32610, U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jing","family":"Li","sequence":"additional","affiliation":[{"name":"Division of Nephrology, Hypertension and Renal Transplantation, Department of Physiology and Functional Genomics, University of Florida College of Medicine, Gainesville, FL 32610, U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Suraj","family":"Krishnan","sequence":"additional","affiliation":[{"name":"Division of Nephrology, Hypertension and Renal Transplantation, Department of Medicine, University of Florida College of Medicine, Gainesville, FL 32610, U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elaine\u00a0M.","family":"Richards","sequence":"additional","affiliation":[{"name":"Division of Nephrology, Hypertension and Renal Transplantation, Department of Physiology and Functional Genomics, University of Florida College of Medicine, Gainesville, FL 32610, U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1654-9597","authenticated-orcid":false,"given":"Mohan\u00a0K.","family":"Raizada","sequence":"additional","affiliation":[{"name":"Division of Nephrology, Hypertension and Renal Transplantation, Department of Physiology and Functional Genomics, University of Florida College of Medicine, Gainesville, FL 32610, U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rajesh","family":"Mohandas","sequence":"additional","affiliation":[{"name":"Division of Nephrology, Hypertension and Renal Transplantation, Department of Medicine, University of Florida College of Medicine, Gainesville, FL 32610, U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"288","published-online":{"date-parts":[[2021,1,5]]},"reference":[{"key":"2021113011183204300_B1","doi-asserted-by":"publisher","first-page":"651","DOI":"10.1161\/HYPERTENSIONAHA.120.15595","article-title":"ACE2 (Angiotensin-Converting Enzyme 2) in cardiopulmonary diseases: ramifications for the control of SARS-CoV-2","volume":"76","author":"Sharma","year":"2020","journal-title":"Hypertension"},{"key":"2021113011183204300_B2","doi-asserted-by":"publisher","first-page":"1456","DOI":"10.1161\/CIRCRESAHA.120.317015","article-title":"Angiotensin converting enzyme 2: SARS-CoV-2 receptor and regulator of the renin-angiotensin system","volume":"126","author":"Gheblawi","year":"2020","journal-title":"Circ. 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