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Circulating ACE2 activity predicts mortality and disease severity in hospitalized COVID-19 patients.
- Source :
-
International journal of infectious diseases : IJID : official publication of the International Society for Infectious Diseases [Int J Infect Dis] 2022 Feb; Vol. 115, pp. 8-16. Date of Electronic Publication: 2021 Nov 25. - Publication Year :
- 2022
-
Abstract
- Objectives: Angiotensin-converting enzyme 2 (ACE2) represents the primary receptor for SARS-CoV-2 to enter endothelial cells. Here we investigated circulating ACE2 activity to predict the severity and mortality of COVID-19.<br />Methods: Serum ACE2 activity was measured in COVID-19 (110 critically ill and 66 severely ill subjects at hospital admission and 106 follow-up samples) and in 32 non-COVID-19 severe sepsis patients. Associations between ACE2, inflammation-dependent biomarkers, pre-existing comorbidities, and clinical outcomes were studied.<br />Results: Initial ACE2 activity was significantly higher in critically ill COVID-19 patients (54.4 [36.7-90.8] mU/L) than in severe COVID-19 (34.5 [25.2-48.7] mU/L; P<0.0001) and non-COVID-19 sepsis patients (40.9 [21.4-65.7] mU/L; P=0.0260) regardless of comorbidities. Circulating ACE2 activity correlated with inflammatory biomarkers and was further elevated during the hospital stay in critically ill patients. Based on ROC-curve analysis and logistic regression test, baseline ACE2 independently indicated the severity of COVID-19 with an AUC value of 0.701 (95% CI [0.621-0.781], P<0.0001). Furthermore, non-survivors showed higher serum ACE2 activity vs. survivors at hospital admission (P<0.0001). Finally, high ACE2 activity (≥45.4 mU/L) predicted a higher risk (65 vs. 37%) for 30-day mortality (Log-Rank P<0.0001).<br />Conclusions: Serum ACE2 activity correlates with COVID-19 severity and predicts mortality.<br /> (Copyright © 2021 The Author(s). Published by Elsevier Ltd.. All rights reserved.)
Details
- Language :
- English
- ISSN :
- 1878-3511
- Volume :
- 115
- Database :
- MEDLINE
- Journal :
- International journal of infectious diseases : IJID : official publication of the International Society for Infectious Diseases
- Publication Type :
- Academic Journal
- Accession number :
- 34838959
- Full Text :
- https://doi.org/10.1016/j.ijid.2021.11.028