Review Article: PDF OnlyCardiovascular Pharmacology in the Time of COVID-19 A Focus on Angiotensin Converting Enzyme 2Buckley, Leo F. PharmD1; Cheng, Judy W.M. PharmD MPH1,2; Desai, Akshay MD MPH3Author Information 1Department of Pharmacy Services, Brigham and Women’s Hospital 2Department of Pharmacy Practice, MCPHS University 3Cardiovascular Division, Brigham and Women’s Hospital Corresponding Author: Leo F. Buckley PharmD, Department of Pharmacy Services, Brigham and Women’s Hospital, Boston, MA 02115, Office: 617-732-4497, Email: LFBuckley@bwh.harvard.edu Conflicts of Interest: None Journal of Cardiovascular Pharmacology: April 13, 2020 - Volume Publish Ahead of Print - Issue - doi: 10.1097/FJC.0000000000000840 Free PAP Metrics Abstract Coronavirus disease-2019 (COVID-19) has emerged as a pandemic affecting millions of adults. Severe acute respiratory syndrome coronavirus-2019 (SARS-CoV-2), the causative virus of COVID-19, infects host cells through angiotensin converting enzyme 2 (ACE2). Pre-clinical models suggest that ACE2 upregulation confers protective effects in acute lung injury. Additionally, renin-angiotensin aldosterone system inhibitors reduce adverse atherosclerotic cardiovascular disease, heart failure and chronic kidney disease outcomes, but may increase ACE2 levels. We review current knowledge of the role of ACE2 in cardiovascular physiology and SARS-CoV-2 virology as well as clinical data to inform the management of patients with or at risk for COVID-19 who require renin-angiotensin-aldosterone system inhibitor therapy. Copyright © 2020 Wolters Kluwer Health, Inc. All rights reserved.