In particular, the injection of SARS-CoV spikes into mice exacerbates acute lung failure in vivo, which can be attenuated by blocking the renin–angiotensin signaling pathway, suggesting that activation of pulmonary RAS influences the pathogenesis of ARDS and SARS.39, 41In autopsies of patients who died from SARS, 35% of heart samples showed the presence of SARS-CoV associated with reduced ACE2 expression.61 Here, ACE2 is linked to severe acute respiratory syndrome.