The potential role of serum angiotensin-converting enzyme in coronavirus disease 2019
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RESEARCH ARTICLE
Open Access
The potential role of serum angiotensinconverting enzyme in coronavirus disease 2019 Zhe Zhu1,2†, Ting Cai2,3†, Lingyan Fan2,4, Kehong Lou2,5, Xin Hua2,5, Zuoan Huang2,6 and Guosheng Gao2,5*
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, SARS-CoV-2, Serum ACE, Clinical significance
Background The newly emerged severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and associated coronavirus disease 2019 (COVID-19) have produced a tremendous global health burden since December 2019. COVID-19 is characterized by fever, dyspnea, dry cough, headache and pneumonia, ranging from mild symptoms to respiratory failure, acute respiratory distress syndrome (ARDS), heart failure, sepsis, and septic shock [1]. The World Health Organization (WHO) announced that it is a public health * Correspondence: [email protected] † Zhe Zhu and Ting Cai contributed equally to this work. 2 Ningbo Institute of Life and Health Industry, University of Chinese Academy of Sciences, Ningbo, P.R. China 5 Department of Clinical Laboratory, HwaMei Hospital, University of Chinese Academy of Sciences, 41 Xibei street, Ningbo, P.R. China Full list of author information is available at the end of the article
emergency of international concern (PHEIC) on January 30, 2020 (https://www.who.int/). The renin–angiotensin system (RAS) is well known for its ability to maintain blood pressure and electrolyte balance. In addition, it has been implicated in the pathogenesis of ARDS [2]. RAS has two axes, classic RAS: the ACE/ Angiotensin (Ang) II/Ang II type 1 (AT1) receptor axis; and nonclassic RAS: the ACE2/Ang 1–7/Mas receptor (MasR) axis. The former deteriorates the impaired respiratory conditions, while the latter plays a protective role in ARDS [2, 3]. Determining what role RAS plays in COVID-19 is helpful to manage and treat thi
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