Abstract
Background
Besides its counterbalancing role of the renin-angiotensin system (RAS), angiotensin-converting enzyme (ACE) 2 is the receptor for the type 2 coronavirus that causes severe acute respiratory syndrome, the etiological agent of COVID-19. COVID-19 is associated with increased plasmatic ACE2 levels, although conflicting results have been reported regarding angiotensin (Ang) II and Ang-(1−7) levels. We investigated plasmatic ACE2 protein levels and enzymatic activity and Ang II and Ang-(1−7) levels in normotensive and hypertensive patients hospitalized with COVID-19 compared to healthy subjects.
Methods
Ang II and Ang-(1−7), and ACE2 activity and protein levels were measured in 93 adults (58 % (n = 54) normotensive and 42 % (n = 39) hypertensive) hospitalized with COVID-19. Healthy, normotensive (n = 33) and hypertensive (n = 7) outpatient adults comprised the control group.
Results
COVID-19 patients displayed higher ACE2 enzymatic activity and protein levels than healthy subjects. Within the COVID-19 group, ACE2 activity and protein levels were not different between normotensive and hypertensive-treated patients, not even between COVID-19 hypertensive patients under RAS blockade treatment and those treated with other antihypertensive medications. Ang II and Ang-(1−7) levels significantly decreased in COVID-19 patients. When COVID-19 patients under RAS blockade treatment were excluded from the analysis, ACE2 activity and protein levels remained higher and Ang II and Ang-(1−7) levels lower in COVID-19 patients compared to healthy people.
Conclusions
Our results support the involvement of RAS in COVID-19, even when patients under RAS blockade treatment were excluded. The increased circulating ACE2 suggest higher ACE2 expression and shedding.
【저자키워드】 COVID-19, hypertension, angiotensin-converting enzyme 2, Angiotensin receptor blockers, angiotensin-converting enzyme inhibitors, angiotensin, 【초록키워드】 Treatment, ACE2, coronavirus, Hospitalized, medications, RAS, renin-angiotensin system, Patient, Ang II, receptor, ACE2 expression, patients, COVID-19 patients, Angiotensin-converting enzyme, Analysis, ACE, ACE2 protein, COVID-19 patient, Support, acute respiratory syndrome, control group, enzymatic activity, healthy subjects, hypertensive, COVID-19 group, circulating, blockade, etiological agent, protein level, Result, significantly, healthy, reported, investigated, remained, treated, cause, not different, were measured, hypertensive patient, normotensive, were excluded, with COVID-19, 【제목키워드】 Hospitalized, renin-angiotensin system, hypertensive patient, normotensive, with COVID-19,