Figure 2. Deregulation of the renin-angiotensin-aldosterone system in COVID-19. : The justaglomerular cells of the afferent arterioles of the nephrons release renin which will convert angiotensinogen into angiotensin I. Then, this molecule is converted into angiotensin II (Ang II) through the action of the angiotensin-converting enzyme 1 (ACE), which is complex with its AT1 receptor (AT1R), leading to a pro-inflammatory, pro-oxidative and pro-fibrotic environment. ACE2 converts angiotensin I and Ang II to Ang 1-7, which produces contrary effects to Ang II when it binds to the Mas receptor (MAS R). A reduction or inhibition of ACE2 is observed in COVID-19 due to the binding of SARS-CoV-2 on the cell surface, leading to more severe pro-inflammatory reactions and more extensive tissue damage. : Adapted with permission from Brandão SCS and cols. (1,31). Created with Biorender.com.