Potential influence of COVID-19/ACE2 on the female reproductive system

• Published in: Molecular Human Reproduction Vol. 26; no. 6; pp. 367 - 373
• Main Authors: Jing, Yan, Run-Qian, Li, Hao-Ran, Wang, Hao-Ran, Chen, Ya-Bin, Liu, Yang, Gao, Fei, Chen
• Format: Journal Article Book Review
• Language: English
• Published: England Oxford University Press 01.06.2020
• Subjects: Adult; Angiotensin I - genetics; Angiotensin I - metabolism; Angiotensin II - genetics; Angiotensin II - metabolism; Angiotensin-Converting Enzyme 2; Betacoronavirus - pathogenicity; Coronavirus Infections - diagnosis; Coronavirus Infections - epidemiology; Coronavirus Infections - pathology; Coronavirus Infections - transmission; COVID-19; Female; Gene Expression Regulation; Genitalia, Female - pathology; Genitalia, Female - virology; Host-Pathogen Interactions - genetics; Humans; Pandemics; Peptide Fragments - genetics; Peptide Fragments - metabolism; Peptidyl-Dipeptidase A - genetics; Peptidyl-Dipeptidase A - metabolism; Pneumonia, Viral - diagnosis; Pneumonia, Viral - epidemiology; Pneumonia, Viral - pathology; Pneumonia, Viral - transmission; Pregnancy; Protein Binding; Receptors, Virus - genetics; Receptors, Virus - metabolism; Renin-Angiotensin System - genetics; Review; SARS-CoV-2; Spike Glycoprotein, Coronavirus - genetics; Spike Glycoprotein, Coronavirus - metabolism; COVID-19; female reproductive system; angiotensin II; pregnancy; coronavirus; angiotensin-converting enzyme 2; 2019-nCoV; Ang-(1-7); breastfeeding
• ISSN: 1460-2407; 1360-9947; 1460-2407
• DOI: 10.1093/molehr/gaaa030

Abstract The 2019 novel coronavirus (2019-nCoV) appeared in December 2019 and then spread throughout the world rapidly. The virus invades the target cell by binding to angiotensin-converting enzyme (ACE) 2 and modulates the expression of ACE2 in host cells. ACE2, a pivotal component of the renin-angiotensin system, exerts its physiological functions by modulating the levels of angiotensin II (Ang II) and Ang-(1-7). We reviewed the literature that reported the distribution and function of ACE2 in the female reproductive system, hoping to clarify the potential harm of 2019-nCoV to female fertility. The available evidence suggests that ACE2 is widely expressed in the ovary, uterus, vagina and placenta. Therefore, we believe that apart from droplets and contact transmission, the possibility of mother-to-child and sexual transmission also exists. Ang II, ACE2 and Ang-(1-7) regulate follicle development and ovulation, modulate luteal angiogenesis and degeneration, and also influence the regular changes in endometrial tissue and embryo development. Taking these functions into account, 2019-nCoV may disturb the female reproductive functions through regulating ACE2.