Efficacy of Serum Angiotensin II Levels in Prognosis of Patients with COVID-19

Abstract

Introduction: The SARS-CoV-2 uses angiotensin converting enzyme 2 (ACE2) as a functional receptor to infect the host cell. It is suggested that serum Angiotensin II levels increase due to the weakening of ACE2 activity by the virus and this directly leads to lung damage. We aimed to determine serum Angiotensin II levels in patients with COVID-19 infection and to investigate the effect of these levels on the prognosis of the disease. Methods: Patients over 18 years of age with positive polymerase chain reaction (PCR) tests and lung involvement diagnosed with COVID-19 infection in the emergency department were included in the study. Blood samples were taken from patients three times for Angiotensin II levels. Angiotensin II levels were studied by ELISA method. Angiotensin II levels were compared in terms of ARDS, need for intensive care unit and mortality. Findings: The serum Angiotensin II levels were statistically significantly lower in the patients with COVID-19 compared with the healthy control group (p 0.05). The serum Angiotensin II levels of the patients with acute respiratory distress syndrome (ARDS) were found to be statistically significantly lower than those without acute respiratory distress syndrome (ARDS) in three samples collected at different clinical periods (p 0.05). Interpretation: The serum Angiotensin II levels decrease significantly in patients with COVID-19 and this decrease is correlated with lung damage. Funding: Financial support of the study was provided by the Istanbul University-Cerrahpaşa Rectorate Scientific Research Projects Coordination Unit (No: TSG-2020-34914, Date: Provided by 28.05.2020).Declaration of Interests: The authors declare that there are no conflicts of interest.Ethics Approval Statement: This study was conducted in accordance with the research rules following the principles of the “World Medical Association Declaration of Helsinki” after obtaining the approval of the Clinical Research Ethics Committee of Istanbul University-Cerrahpasa, Cerrahpasa Faculty of Medicine (Date: 13.05.2020).