A low aldosterone/renin ratio and high soluble ACE2 activity associate with COVID-19 severity
| Autor: | Hassan El Bouazzaoui, T.L.Th.A. Jansen, Sakir Akin, Erik J van Helden, Vincent van Driel, Remon Baak, Ronne A T A Mairuhu, Ingrid M. Garrelds, Koen Verdonk, Jan Kees van Rooden, Evert de Jonge, Iwan A. Meynaar, Kadir Caliskan, Johannes F A B Duynstee, Paula Schriek, Jeroen Ludikhuize, Ron H.N. van Schaik, Cees van Nieuwkoop, Rugina I. Neuman, A.H. Jan Danser, Loes E. Visser, Marjan Veuger, Lettie van den Berg |
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| Přispěvatelé: | Cardiology, Internal Medicine, Clinical Chemistry |
| Jazyk: | angličtina |
| Rok vydání: | 2022 |
| Předmět: |
medicine.medical_specialty
Physiology medicine.medical_treatment TMPRSS2 Renin-Angiotensin System Serine chemistry.chemical_compound Internal medicine Renin Genotype Renin–angiotensin system Internal Medicine Humans Medicine Receptor Aldosterone Serine protease Protease biology SARS-CoV-2 business.industry Serine Endopeptidases COVID-19 Endocrinology chemistry biology.protein Angiotensin-Converting Enzyme 2 Cardiology and Cardiovascular Medicine business |
| Zdroj: | Journal of Hypertension, 40(3), 606-614. Lippincott Williams & Wilkins |
| ISSN: | 0263-6352 |
| Popis: | Background The severity of COVID-19 after SARS-CoV-2 infection is unpredictable. Angiotensin-converting enzyme-2 (ACE2) is the receptor responsible for coronavirus binding, while subsequent cell entry relies on priming by the serine protease TMPRSS2 (transmembrane protease, serine 2). Although renin-angiotensin-aldosterone-system (RAAS) blockers have been suggested to upregulate ACE2, their use in COVID-19 patients is now considered safe. The aim of our study was to investigate parameters that determine COVID-19 severity, focusing on RAAS-components and variation in the genes encoding for ACE2 and TMPRSS2.MethodsAdult patients hospitalized due to SARS-CoV-2 infection between May 2020 and October 2020 in the Haga Teaching Hospital were included, and soluble ACE2 (sACE2), renin, aldosterone (in heparin plasma), and polymorphisms in the ACE2 and TMPRSS2 genes (in DNA obtained from EDTA blood) were determined. Measurements and main resultsOf the 188 patients that were included, 60 were defined as severe COVID-19 (ICU and/or death). These patients more often used antidiabetic drugs, were older, had higher renin and sACE2 levels, lower aldosterone levels, and a lower aldosterone/renin ratio. In addition, they displayed the TMPRSS2-rs2070788 AA genotype less frequently. No ACE2 polymorphism-related differences were observed. Multivariate regression analysis revealed independent significance for age, sACE2, the aldosterone/renin ratio, and the TMPRSS2 rs2070788 non-AA genotype as predictors of COVID-19 severity, together yielding a C-index of 0.79. Findings were independent of the use of RAAS blockers. Conclusion High sACE2, a low aldosterone/renin ration, and having the TMPRSS2 rs2070788 non-AA genotype are novel independent determinants that may help to predict COVID-19 disease severity. Trial registration: retrospectively registered |
| Databáze: | OpenAIRE |
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