The Aldosterone Crisis Hypothesis – “Covid Syndrome”
The RAAS helps maintain interstitial fluid homeostasis and tissue
perfusion and has a central role in the cardiovascular injury through
inflammatory mechanisms. Aldosterone is a powerful pro-inflammatory
steroid hormone and aldosterone-mediated stress is directly implicated
in obesity, hypertension, cardiovascular, renal and respiratory
diseases, diabetes, cancer and inflammation; matching the profile of
COVID-19-susceptible patients. (5,6) RAAS-blocking pharmaceuticals have
shown enough promise in COVID-19 to encourage further study.
This author hypothesizes that acute ACE2 depletion in COVID-19 induces
acute-on-chronic RAAS stress mediated by excessive Ang II and
aldosterone levels, which together activate the severe inflammatory and
oxidative stress responses that contribute to the spectrum of organ
dysfunctions, “Covid Syndrome”, encountered by these patients.
Blocking aldosterone production and activity, alone or in concert with
other RAAS suppressing/counteractive treatments that correct the
susceptible host derangement, may provide a logical, safe and
immediately available treatment approach.