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Angiotensin-converting enzyme 2 (ACE2) is a membrane-bound aminopeptidase that has a vital role in the cardiovascular and immune systems4. ACE2 is involved in heart function and the development of hypertension and diabetes mellitus. In addition, ACE2 has been identified as a functional receptor for coronaviruses4, including SARS-CoV and SARS-CoV-2. SARS-CoV-2 infection is triggered by binding of the spike protein of the virus to ACE2, which is highly expressed in the heart and lungs4. SARS-CoV-2 mainly invades alveolar epithelial cells, resulting in respiratory symptoms. These symptoms are more severe in patients with CVD, which might be associated with increased secretion of ACE2 in these patients compared with healthy individuals. ACE2 levels can be increased by the use of renin–angiotensin–aldosterone system inhibitors. Given that ACE2 is a functional receptor for SARS-CoV-2, the safety and potential effects of antihypertension therapy with ACE inhibitors or angiotensin-receptor blockers in patients with COVID-19 should be carefully considered. Whether patients with COVID-19 and hypertension who are taking an ACE inhibitor or angiotensin-receptor blocker should switch to another antihypertensive drug remains controversial, and further evidence is required.