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. 2020 Nov 25;20(1):883.
doi: 10.1186/s12879-020-05619-x.

The potential role of serum angiotensin-converting enzyme in coronavirus disease 2019

Zhe Zhu  1   2 , Ting Cai  2   3 , Lingyan Fan  2   4 , Kehong Lou  2   5 , Xin Hua  2   5 , Zuoan Huang  2   6 , Guosheng Gao  7   8
Affiliations

The potential role of serum angiotensin-converting enzyme in coronavirus disease 2019

Zhe Zhu et al. BMC Infect Dis. .

Abstract

Background: To explore the clinical significance of serum angiotensin-converting enzyme (ACE) activity in coronavirus disease 2019 (COVID-19).

Methods: In this retrospective study, a total of 136 consecutive patients with confirmed COVID-19 were recruited. Demographic and clinical data were recorded. The serum ACE activity was measured at baseline and during the recovery phase, and its relationship with clinical condition was analyzed.

Results: Of the 136 patients with confirmed COVID-19, the 16 severe patients were older and had a higher body mass index (BMI) and proportion of hypertension than the 120 nonsevere patients. In comparison to those of normal controls, the baseline serum ACE activities of subjects in the severe group and nonsevere group were decreased, with the lowest level in the severe group. However, the serum ACE activity increased in the recovery phase, and there were no significant differences among the severe group, nonsevere group and normal control group.

Conclusion: Serum ACE activity could be used as a marker to reflect the clinical condition of COVID-19 since low activity was associated with the severity of COVID-19 at baseline, and the activity increased with the remission of the disease.

Keywords: COVID-19; Clinical significance; SARS-CoV-2; Serum ACE.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Fig. 1
Fig. 1
The association between baseline serum ACE activity and other variables in patients with COVID-19. The activity of serum ACE in male and female patients (a); the activity of serum ACE in patients with and without hypertension (b); correlations between serum ACE activity and age (c), BMI (d), fibrinogen (e), platelet count (f), WBC count (g), neutrophil% (h), lymphocyte% (i), neutrophil count (j), lymphocyte count (k), NLR (l), sialic acid (m), C-reactive protein (n), ESR (o), systolic blood pressure (p) and diastolic blood pressure (q). ACE: angiotensin-converting enzyme; COVID-19: coronavirus disease 2019; BMI: body mass index; WBC: white blood cell; NLR: neutrophil-to-lymphocyte ratio; ESR: erythrocyte sedimentation rate
Fig. 2
Fig. 2
The comparisons of serum ACE activity among nonsevere group, severe group and normal controls at baseline (a) and recovery phase (b); the dynamic changes of serum ACE activity in patients with COVID-19 (c). Ninety-seven nonsevere cases and 8 severe cases tested serum ACE activity in the recovery phase
See this image and copyright information in PMC

References

    1. Tu H, Tu S, Gao S, Shao A, Sheng J. Current epidemiological and clinical features of COVID-19; a global perspective from China. J Inf Secur. 2020; 10.1016/j.jinf.2020.04.011. - PMC - PubMed
    1. Imai Y, Kuba K, Penninger JM. The renin-angiotensin system in acute respiratory distress syndrome. Drug Discov Today Dis Mech. 2006;3(2):225–229. doi: 10.1016/j.ddmec.2006.06.012. - DOI - PMC - PubMed
    1. Imai Y, Kuba K, Penninger JM. Angiotensin-converting enzyme 2 in acute respiratory distress syndrome. Cell Mol Life Sci. 2007;64(15):2006–2012. doi: 10.1007/s00018-007-6228-6. - DOI - PMC - PubMed
    1. Monteil V, Kwon H, Prado P, Hagelkrüys A, Wimmer RA, Stahl M, et al. Inhibition of SARS-CoV-2 Infections in Engineered Human Tissues Using Clinical-Grade Soluble Human ACE2. Cell. 2020;181(4):905–913. doi: 10.1016/j.cell.2020.04.004. - DOI - PMC - PubMed
    1. Chan KK, Dorosky D, Sharma P, Abbasi SA, Dye JM, Kranz DM, et al. Engineering human ACE2 to optimize binding to the spike protein of SARS coronavirus 2. Science. 2020;369(6508):1261–1265. doi: 10.1126/science.abc0870. - DOI - PMC - PubMed