Renin-angiotensin-aldosterone system peptide profiles in patients with COVID-19.
Eur J Endocrinol
; 184(4): 543-552, 2021 Apr.
Article
in English
| MEDLINE | ID: covidwho-1067456
ABSTRACT
OBJECTIVE:
While evidence on the interface between severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and the renin-angiotensin-aldosterone-system (RAAS) is accumulating, clinical data on RAAS peptide alteration among coronavirus disease-19 (COVID-19) patients is missing. DESIGN ANDMETHODS:
In this exploratory study, we prospectively included adult patients (aged ≥ 18 years) admitted between February 26 and April 30, 2020 to a tertiary care hospital in Switzerland. We assessed the association of an underlying SARS-CoV-2 infection and equilibrium serum levels of RAAS peptides in hospitalized COVID-19 patients 11 propensity-score matched with patients suffering from SARS-CoV-2-negative respiratory infections. Subgroup analyses involved stratification for taking RAAS inhibitors.RESULTS:
COVID-19 patients had about 50% lower equilibrium serum RAAS peptide levels as compared with matched controls (angiotensin I 31.6 vs 66.8 pmol/L, -52.7% (95%CI -68.5% to -36.9%); angiotensin II 37.7 vs 92.5 pmol/L, -59.2% (95%CI -72.1% to -46.3%); angiotensin (1-5) 3.3 vs 6.6 pmol/L, -49.7% (95%CI -59.2% to -40.2%); angiotensin (1-7) 4.8 vs 7.6 pmol/L, -64.9% (95%CI -84.5% to -45.3%)). While the plasma renin activity was lower in COVID-19 patients (88.6 vs 207.9 pmol/L, -58.5% (95%CI -71.4% to -45.6%)), there was no difference of angiotensin-converting enzyme (ACE) and ACE2 plasma activity between the groups. Subgroup analyses revealed a pronounced RAAS peptide profile depression in COVID-19 patients among those not on RAAS inhibitors.CONCLUSIONS:
As compared with SARS-CoV-2-negative patients, we found a downregulated RAAS in presence of a SARS-CoV-2 infection. Whether the lower levels of the protective angiotensin (1-5) and (1-7) are linked to adverse outcomes in COVID-19 warrants further investigation.
Full text:
Available
Collection:
International databases
Database:
MEDLINE
Main subject:
Peptide Fragments
/
Angiotensin I
/
Angiotensin II
/
Renin
/
Peptidyl-Dipeptidase A
/
Angiotensin-Converting Enzyme 2
/
COVID-19
Type of study:
Cohort study
/
Experimental Studies
/
Observational study
/
Prognostic study
/
Randomized controlled trials
Limits:
Aged
/
Female
/
Humans
/
Male
/
Middle aged
Language:
English
Journal:
Eur J Endocrinol
Journal subject:
Endocrinology
Year:
2021
Document Type:
Article
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