A dramatic rise in serum ACE2 activity in a critically ill COVID-19 patient

Autor: Béla Nagy, Jr, Zsolt Fejes, Zoltán Szentkereszty, Renáta Sütő, István Várkonyi, Éva Ajzner, János Kappelmayer, Zoltán Papp, Attila Tóth, Miklós Fagyas
Jazyk: angličtina
Rok vydání: 2021
Předmět:
Zdroj: International Journal of Infectious Diseases, Vol 103, Iss , Pp 412-414 (2021)
Druh dokumentu: article
ISSN: 1201-9712
DOI: 10.1016/j.ijid.2020.11.184
Popis: Endothelial cells express surface angiotensin-converting enzyme 2 (ACE2), the main receptor for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) that promotes the infection of endothelial cells showing activation and damage. Bronchoalveolar lavage fluid from coronavirus disease-2019 (COVID-19) subjects showed a critical imbalance in the renin-angiotensin-aldosterone system with the upregulated expression of ACE2. Recently, intravenous recombinant ACE2 was reported as an effective therapy in severe COVID-19 by blocking the viral entry to target cells. Here, we present a case of a critically ill COVID-19 patient with acute respiratory distress syndrome where circulating ACE2 was first measured to monitor disease prognosis. ACE2 activity increased about 40-fold over the normal range and showed a distinct time course as compared to 2-3-fold higher levels of endothelium biomarkers. Although the level of soluble E-selectin followed the clinical status of our patient similar to ferritin and IL-6 levels, the dramatic rise in serum ACE2 activity may act as an endogenous nonspecific protective mechanism against SARS-CoV-2 infection that preceded the recovery of our patient.
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