Serum ACE activity and plasma ACE concentration in patients with SARS-CoV-2 infection

Abstract Significant controversy has arisen over the role of the renin-angiotensin-aldosterone system (RAAS) in COVID-19 pathophysiology. In this prospective, observational study, we evaluated plasma angiotensin converting enzyme (ACE) concentration and serum ACE activity in 52 adults with laboratory-confirmed SARS-CoV-2 infection and 27 non-COVID-19 sick controls. No significant differences were observed in ACE activity in COVID-19 patients versus non-COVID-19 sick controls (41.1 [interquartile range (IQR): 23.0–55.2] vs. 42.9 [IQR 13.6–74.2] U/L, p = .649, respectively). Similarly, no differences were observed in ACE concentration in COVID-19 patients versus non-COVID-19 sick controls (108.4 [IQR: 95.8–142.2] vs. 133.8 [IQR: 100.2–173.7] μg/L, p = .059, respectively). Neither ACE activity (p = .751), nor ACE concentration (p = .283) was associated with COVID-19 severity. Moreover, neither ACE activity, nor ACE concentration was correlated with any inflammatory biomarkers.

[1]  G. Erbaş,et al.  The assessment of serum ACE activity in COVID-19 and its association with clinical features and severity of the disease , 2021, Scandinavian journal of clinical and laboratory investigation.

[2]  H. Busch,et al.  Serum ACE-2, angiotensin II, and aldosterone levels are unchanged in patients with COVID-19 , 2020, American journal of hypertension.

[3]  G. Lippi,et al.  Coronavirus disease 2019 is associated with low circulating plasma levels of angiotensin 1 and angiotensin 1,7 , 2020, Journal of medical virology.

[4]  G. Lippi,et al.  Validation of the Corona-Score for rapid identification of SARS-CoV-2 infections in patients seeking emergency department care in the United States , 2020, Clinical chemistry and laboratory medicine.

[5]  G. Lippi,et al.  False negative RT-PCR or false positive serological testing in SARS-CoV-2 diagnostics? Navigating between Scylla and Charybdis to prevent misclassification bias in COVID-19 clinical investigations , 2020, Diagnosis.

[6]  Letter to the Editor - Circulating plasma levels of angiotensin II and aldosterone in patients with coronavirus disease 2019 (COVID-19): A preliminary report , 2020, Progress in Cardiovascular Diseases.

[7]  G. Lippi,et al.  Angiotensin-Converting Enzyme 2 and Antihypertensives (Angiotensin Receptor Blockers and Angiotensin-Converting Enzyme Inhibitors) in Coronavirus Disease 2019 , 2020, Mayo Clinic Proceedings.

[8]  Jing Yuan,et al.  Clinical and biochemical indexes from 2019-nCoV infected patients linked to viral loads and lung injury , 2020, Science China Life Sciences.

[9]  J. Laffey,et al.  Angiotensin-(1-7) improves oxygenation, while reducing cellular infiltrate and fibrosis in experimental Acute Respiratory Distress Syndrome , 2015, Intensive Care Medicine Experimental.