Acute respiratory coronavirus 2 (SARS-CoV-2) syndrome, the virus that causes the coronavirus infection (COVID-19), enters human cell hosts through the binding of the protein and angiotensin spike receptors -enzyme conversion (ACE2).
Researchers at Aarhus University, Denmark, found that high baseline levels of ACE2 in plasma from COVID-19 patients are associated with a worse outcome in hospitalized patients. The scan, which appeared on the pre-print server medRxiv *, shows that measuring serum ACE2 levels can help diagnose patients at higher risk of developing severe disease from SARS-CoV-2 infection.
Study background
SARS-CoV-2 infection occurs when a person ingests infected respiratory droplets that have been released when an individual coughs, sneezes, talks , or breathing. The condition can cause severe infection in those at high risk, such as the elderly and people with comorbidities. These include heart disease, kidney disease, respiratory disease, diabetes and hip tolerance, among others.
To cause infection, SARS-CoV-2 enters host cells by binding its spike protein to human ACE2 receptors, using membrane fusion and endocytosis.
ACE2 receptors are widely distributed in the human body, including the vascular endothelial cells, nasal and oral mucosa, smooth muscle cells, enterocytes in the intestines, and the type II alveolar pneumocytes in the lungs. This explains why COVID-19 affects many organs in the body and can cause serious complications in some people.
ACE2 is part of the renin-angiotensin-aldosterone system (RAAS). ACE2 counteracts the effects of RAAS, reducing elevations in blood pressure. When RAAS is managed, it can cause many diseases such as hip injury and kidney disease.
Human ACE2 receptor, 3D image. Image credit: Kateryna Kon / Shutterstock
The study
In the study, the researchers aimed to determine whether higher levels of ACE2 in the blood of COVID-19 patients could predict clinical outcomes.
To reach the conclusions of the study, the team used data from a large-scale study of 306 patients with COVID-19 and 78 patients without COVID-19. They collected clinical data, including clinical results after 28 days.
To test serum ACE2 levels, the team collected blood samples from positive patients on days 0, 3, and 7. Negative blood was drawn on negative patients on the first day. The researchers tested the samples on the Olink Explore platform to measure ACE2 levels.
The team found that high baseline ACE2 levels in plasma of COVID-19 patients are associated with the worst WHOmax region at 28 days. The WHOmax section, also known as the World Health Organization (WHO) COVID-19 outcome scale, confirms the severity of the disease. The lower the score, the worse the outcome of the disease.
Further, elevated levels of ACE2 in plasma from COVID-19 patients were significantly associated with worsening WHO segmentation during blood sampling at day 0, day 3, and day 7. Plasma ACE2 was higher in the blood in patients with high blood pressure. -tolerance compared to those without great tolerance.
Patients with comorbidities had higher ACE2 levels, including those with kidney disease and heart disease. However, there was no difference in plasma ACE2 levels in patients with diabetes, immunosuppressive conditions, and lung disease compared with those without these comorbidities.
Overall, the study suggests a potential role in the measurement of ACE2 in COVID-19 to predict disease outcomes. Also, ACE2 levels may be linked to severe COVID-19 infection and the various risk factors.
The researchers argue that high levels of ACE2 in the plasma may be due to lysis of ACE2-express cells as a result of malignancy. They also said it will help identify those who are more likely to get bad symptoms in the treatment process.
“It is desirable to predict the consequences of disease specializing in treatment because the drugs used in the treatment of COVID-19 can have adverse effects,” they explained.
* Important message
medRxiv publish preliminary scientific reports that are not peer-reviewed and, therefore, should not be seen as final, guiding health-related clinical practice / behavior, or be treated as information established.