Figure 1 SARS-CoV-2 downregulates ACE2 to cause cardiovascular injuries. SARS-CoV-2 downregulates ACE2 by suppressing transcription of the ACE2 gene, cutting the extracellular segment of ACE2, and increasing internalization with ACE2, leading to increased Ang II expression and TACE activation, thus elevating the expression level of TNF-α and the risk of cardiovascular adverse events. The downregulation of ACE2 occurring in the heart, lung, hypothalamus, and kidney can all increase the load on the cardiovascular system.