ACE2 and ANGII levels in patients with COVID-19 based on thoracic tomography findings and PCR test results

Afsin Ipekci; Serap Biberoglu; Ibrahim Ikizceli; Fatih Cakmak; Yonca Senem Akdeniz; Altug Kanbakan; Dildar Konukoglu; Ibrahim Murat Bolayirli; Sermin Borekci; Seval Urkmez; Seda Ozkan

doi:10.3855/jidc.15438

Authors

Afsin Ipekci Department of Emergency Medicine, Cerrahpasa Faculty of Medicine, Istanbul University-Cerrahpasa, Istanbul, Turkey https://orcid.org/0000-0001-6125-4061
Serap Biberoglu Department of Emergency Medicine, Cerrahpasa Faculty of Medicine, Istanbul University-Cerrahpasa, Istanbul, Turkey https://orcid.org/0000-0003-4709-3315
Ibrahim Ikizceli Department of Emergency Medicine, Cerrahpasa Faculty of Medicine, Istanbul University-Cerrahpasa, Istanbul, Turkey https://orcid.org/0000-0002-9825-4716
Fatih Cakmak Department of Emergency Medicine, Cerrahpasa Faculty of Medicine, Istanbul University-Cerrahpasa, Istanbul, Turkey https://orcid.org/0000-0002-0333-3834
Yonca Senem Akdeniz Department of Emergency Medicine, Cerrahpasa Faculty of Medicine, Istanbul University-Cerrahpasa, Istanbul, Turkey https://orcid.org/0000-0002-4843-1155
Altug Kanbakan Department of Emergency Medicine, Yuksekova State Hospital, Hakkari, Turkey https://orcid.org/0000-0002-1063-3018
Dildar Konukoglu Department of Medical Biochemistry, Cerrahpasa Faculty of Medicine, Istanbul University-Cerrahpasa, Istanbul, Turkey https://orcid.org/0000-0002-6095-264X
Ibrahim Murat Bolayirli Department of Medical Biochemistry, Cerrahpasa Faculty of Medicine, Istanbul University-Cerrahpasa, Istanbul, Turkey https://orcid.org/0000-0001-5755-7860
Sermin Borekci Department of Pulmonology, Cerrahpasa Faculty of Medicine, Istanbul University-Cerrahpasa, Istanbul, Turkey https://orcid.org/0000-0002-0089-1312
Seval Urkmez Department of Anesthesia and Reanimation, Cerrahpasa Faculty of Medicine, Istanbul University-Cerrahpasa, Istanbul, Turkey https://orcid.org/0000-0002-3412-4226
Seda Ozkan Department of Emergency Medicine, Cerrahpasa Faculty of Medicine, Istanbul University-Cerrahpasa, Istanbul, Turkey https://orcid.org/0000-0003-1835-8820

DOI:

https://doi.org/10.3855/jidc.15438

Keywords:

Angiotensin-converting enzyme 2, angiotensin II, acute respiratory distress syndrome, COVID-19

Abstract

Introduction: Reverse transcriptase polymerase chain reaction tests and thoracic tomography have been widely employed in the diagnosis of the disease, but doubts about their sensitivity still persist. Also there are controversial results about ACE2 and AngII levels according to the severity of disease. In this study, we aimed to analyze the ACE2 and AngII levels in patients with suspected COVID-19 based on polymerase chain reaction test results and thoracic tomography findings and to examine their relationship with disease severity.

Methodology: Patients with suspected COVID-19 in the emergency department were divided into 4 groups according to thoracic tomography findings and PCR test results. The in-hospital mortality of patients was recorded. ACE2 and AngII levels in patients were analyzed according to groups and severity of the disease.

Results: ACE2 levels for the patients with suspected COVID-19 were significantly lower than in the control group, but AngII levels were higher (not statistically significant). The mean age and male sex ratio of patients who developed acute respiratory distress syndrome (ARDS) and died were significantly higher than those who survived. Whereas there was no difference in ACE2 levels in patients with severe diseases such as ARDS and mortality, their AngII levels were significantly lower.

Conclusions: It can be suggested that decreased ACE2 levels combined with increased AngII levels are determinative at disease onset and in the development of lung damage. However, decreased AngII levels are more determinative in patients with severe diseases such as ARDS and mortality.