Evidence map›Paper›PMID 34361021›Full record

ReviewInternational journal of molecular sciences2021

Role of the Renin-Angiotensin-Aldosterone and Kinin-Kallikrein Systems in the Cardiovascular Complications of COVID-19 and Long COVID.

Samantha L Cooper, Eleanor Boyle, Sophie R Jefferson, Calum R A Heslop, Pirathini Mohan, Gearry G J Mohanraj, Hamza A Sidow, Rory C P Tan, Stephen J Hill, Jeanette Woolard

Open access · goldAbstract readReview
In one paragraph

Review in International journal of molecular sciences, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 38 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
38citing papers in PubMed, 1 pooled it
3.7field-weighted citation impact, top 5% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

38 citing papers in PubMed, 1 synthesis or guideline pooled it, 66 citations in OpenAlex.

  1. Pooled it
  2. Trial
  3. "Bridging the clinical, molecular and genetic perspectives on myocarditis in post-COVID-19 era".International journal of cardiology. Cardiovascular risk and prevention · 2026
    Review
  4. Article
  5. Article
  6. Kidney involvement and anemia in COVID-19 infection.World journal of nephrology · 2025
    Review
  7. Review
  8. Article
  9. Article
  10. Article
  11. Article
  12. Article
  13. Review
  14. Review
  15. Article
  16. Article
  17. Review
  18. Review
  19. Article
  20. SGLT2 Inhibitors in Long COVID Syndrome: Is There a Potential Role?Journal of cardiovascular development and disease · 2023
    Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors at 1 institution in 1 country.

Samantha L CooperDivision of Physiology, Pharmacology and Neuroscience, School of Life Sciences, University of Nottingham, Nottingham NG7 2UH, UK.
Eleanor BoyleSchool of Medicine, Queen's Medical Centre, University of Nottingham, Nottingham NG7 2UH, UK.
Sophie R JeffersonSchool of Medicine, Queen's Medical Centre, University of Nottingham, Nottingham NG7 2UH, UK.
Calum R A HeslopSchool of Medicine, Queen's Medical Centre, University of Nottingham, Nottingham NG7 2UH, UK.ORCID 0000-0001-6066-3410
Pirathini MohanSchool of Medicine, Queen's Medical Centre, University of Nottingham, Nottingham NG7 2UH, UK.
Gearry G J MohanrajSchool of Medicine, Queen's Medical Centre, University of Nottingham, Nottingham NG7 2UH, UK.
Hamza A SidowSchool of Medicine, Queen's Medical Centre, University of Nottingham, Nottingham NG7 2UH, UK.
Rory C P TanSchool of Medicine, Queen's Medical Centre, University of Nottingham, Nottingham NG7 2UH, UK.
Stephen J HillDivision of Physiology, Pharmacology and Neuroscience, School of Life Sciences, University of Nottingham, Nottingham NG7 2UH, UK.ORCID 0000-0002-4424-239X
Jeanette WoolardDivision of Physiology, Pharmacology and Neuroscience, School of Life Sciences, University of Nottingham, Nottingham NG7 2UH, UK.ORCID 0000-0001-5406-6847
University of Nottingham · GB

Funding

Medical Research Council MR/N020081/1
6 · The paper itself

Abstract

Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) is the virus responsible for the COVID-19 pandemic. Patients may present as asymptomatic or demonstrate mild to severe and life-threatening symptoms. Although COVID-19 has a respiratory focus, there are major cardiovascular complications (CVCs) associated with infection. The reported CVCs include myocarditis, heart failure, arrhythmias, thromboembolism and blood pressure abnormalities. These occur, in part, because of dysregulation of the Renin-Angiotensin-Aldosterone System (RAAS) and Kinin-Kallikrein System (KKS). A major route by which SARS-CoV-2 gains cellular entry is via the docking of the viral spike (S) protein to the membrane-bound angiotensin converting enzyme 2 (ACE2). The roles of ACE2 within the cardiovascular and immune systems are vital to ensure homeostasis. The key routes for the development of CVCs and the recently described long COVID have been hypothesised as the direct consequences of the viral S protein/ACE2 axis, downregulation of ACE2 and the resulting damage inflicted by the immune response. Here, we review the impact of COVID-19 on the cardiovascular system, the mechanisms by which dysregulation of the RAAS and KKS can occur following virus infection and the future implications for pharmacological therapies.

Indexed as

Kallikrein-Kinin SystemRenin-Angiotensin SystemAngiotensin-Converting Enzyme 2BradykininCardiovascular DiseasesCOVID-19COVID-19 Drug TreatmentCytokine Release SyndromeHumansPost-Acute COVID-19 SyndromeACE2 protein, humanAngiotensin-Converting Enzyme 2Bradykinincardiovascular systemCOVID-19kinin–kallikrein systemlong COVIDrenin–angiotensin–aldosterone system

Identifiers

PMID34361021
PMCPMC8347967
OpenAlexW3192534922

What Socratic holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.