Serum Angiotensin II Level in Pediatric Patients with COVID-19 and its Correlation with the Disease Severity
Abstract Background Coronavirus disease 2019 (COVID-19) is a newly discovered RNA betacoronavirus infection. It has been caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Angiotensin II (Ang-II) is a mitochondrial toxin that under normal circumstances is rapidly removed by angi...
Saved in:
| Published in: | QJM : An International Journal of Medicine Vol. 117; no. Supplement_1 |
|---|---|
| Main Authors: | , , , |
| Format: | Journal Article |
| Language: | English |
| Published: |
03-07-2024
|
| Online Access: | Get full text |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| Summary: | Abstract Background Coronavirus disease 2019 (COVID-19) is a newly discovered RNA betacoronavirus infection. It has been caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Angiotensin II (Ang-II) is a mitochondrial toxin that under normal circumstances is rapidly removed by angiotensin converting enzyme 2 (ACE-2). SARS-CoV-2 uses the receptor ACE-2 for host cell entry and viral replication. ACE-2 proteins are occupied and downregulated by SARS-CoV-2. ACE-2 downregulation has been directly linked to toxic over accumulation of Ang-II. Accumulating Ang-II triggers many severe and fatal conditions such as acute respiratory distress syndrome (ARDS). Aim of the Work To assess the serum level of Ang-II and correlate it with the severity of COVID-19 infection in pediatric patients. Patients and Methods This case control study was conducted on 45 positive COVID-19 RT-PCR children who were compared to age and sex matched 45 healthy controls. Clinical examination, laboratory assays and imaging studies were done for the patients group to assess the severity of COVID–19 infection. Serum Ang-II was measured by ELISA for both groups and correlated with clinical (heart rate, blood pressure, respiratory rate and oxygen saturation), laboratory (total leucocytic count, lymphocytes, neutrophils, serum ferritin, ESR and CRP) and radiological (chest x-ray and CORAD score of CT chest ) parameters of the patients. Results The median “IQR” of serum Ang-II was significantly higher in the COVID-19 patients than in the controls (100 (88-137) ng/L) versus 20 (15-25) ng/L) (p-value= 0.001). There were statistically significant positive correlations between serum Ang-II levels and different grades of clinical severity classification (rs = 0.92, p-value=0.001) and CORAD score of CT chest. On the other hand, no statistically significant correlations were found between serum levels of Ang-II and total leucocytic count, lymphocytes, neutrophils, ESR and CRP. Conclusion Serum Ang-II could be used as a biomarker in predicting the severity of COVID-19 infection in pediatrics. |
|---|---|
| ISSN: | 1460-2725 1460-2393 |
| DOI: | 10.1093/qjmed/hcae070.440 |