The Relationship between Covid-19, ACE-2, Pregnancy, and Vitamin D

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edit: I have included an additional resources at the bottom of this blog post that was foundational in my understanding of Covid-19 as a novel virus.

TL;DR Video Version

The 6 minute version specific to pregnancy and Covid-19

Covid-19 binds to a receptor in the lungs associated with relaxing blood vessels called ACE-2. There is some evidence that if the receptors are filled with the enzyme, there aren’t as many docking stations for Covid-19 to latch onto the lung cells. This video covers 3 things that help the body make more circulating ACE-2: Estrogen, having a placenta, and Vitamin D. Emerging evidence suggests these may have a protective effect. However elderly patients (low estrogen) with cardiovascular disease, pregnant patients with pre-eclampsia, and people who are low in Vitamin D levels may be at greater risk for Covid-19 infection.

Uncut Video

The full 19 minute version, with additional information and theories based on current research.

This is the full, uncut video that includes information and theories on ACE-2 enzymes and receptors, Covid-19, elderly patients, why those on blood pressure medication should stay on it, estrogen, placental influences on ACE-2, Vitamin D influences on ACE-2, and Vitamin D influences on pre-eclampsia. It also contains theories on why younger Americans who are obese, sedentary, and Vitamin D deficient may be at risk for contracting this disease.

References

Bukowska, A. et al (2017). Protective regulation of the ACE2/ACE gene expression by estrogen in human atrial tissue from elderly men. Experimental biology and medicine (Maywood, N.J.), 242(14), 1412–1423. https://doi.org/10.1177/1535370217718808

Garami A. Rapid Response: Re: Preventing a covid-19 pandemic – Is there a magic bullet to save COVID-19 patients? We can give it a try! Mar 12 2020 BMJ 2020;368:m810

Olshansky J. et al (2005).  A Potential Decline in Life Expectancy in the United States in the 21st Century. N Engl J Med 2005; 352:1138-1145
DOI: 10.1056/NEJMsr043743.

Purswani, J. M., et al (2017). The role of vitamin D in pre-eclampsia: a systematic review. BMC pregnancy and childbirth, 17(1), 231. https://doi.org/10.1186/s12884-017-1408-3

Sparks M & Hiremath S (eds). The Coronavirus Conundrum: ACE2 and Hypertension Edition. Mar 22 2020 http://www.nephjc.com/news/covidace2

Wang Y (2017). Vascular Biology of the Placenta (2nd ed). (pp 49-51).  Biota Publishing, accessed on Google Books.

Zhu N. et al (2020). A Novel Coronavirus from Patients with Pneumonia in China, 2019. N Engl J Med 2020; 382:727-733 DOI: 10.1056/NEJMoa2001017

 

Image Credits

Covid-19 image: ewscripps.brightspotcdn.com

Kocovska E. et al 2017 “Vitamin-D Deficiency As a Potential Environmental Risk Factor in Multiple Sclerosis, Schizophrenia, and Autism.” Front. Psychiatry, 27 March 2017 https://doi.org/10.3389/fpsyt.2017.00047