Serum ACE2, Angiotensin II, and Aldosterone Levels Are Unchanged in Patients With COVID-19

• Published in: American journal of hypertension Vol. 34; no. 3; pp. 278 - 281
• Main Authors: Rieder, Marina, Wirth, Luisa, Pollmeier, Luisa, Jeserich, Maren, Goller, Isabella, Baldus, Niklas, Schmid, Bonaventura, Busch, Hans-Joerg, Hofmann, Maike, Kern, Winfried, Bode, Christoph, Duerschmied, Daniel, Lother, Achim
• Format: Journal Article
• Language: English
• Published: US Oxford University Press 02-04-2021
• Subjects: Aldosterone - blood; Angiotensin II - blood; Angiotensin-Converting Enzyme 2 - blood; Angiotensin-Converting Enzyme Inhibitors - therapeutic use; Blood Pressure Determination - statistics & numerical data; COVID-19 - blood; COVID-19 - diagnosis; COVID-19 - epidemiology; COVID-19 - physiopathology; Female; Germany - epidemiology; Humans; Hypertension - blood; Hypertension - drug therapy; Hypertension - epidemiology; Hypertension - physiopathology; Male; Middle Aged; Outcome Assessment, Health Care; Potassium - blood; Prospective Studies; Renin-Angiotensin System - physiology; SARS-CoV-2 - isolation & purification; Germany; COVID-19; ACE2; blood pressure; SARS-CoV-2; aldosterone; angiotensin II; hypertension
• ISSN: 0895-7061; 1941-7225
• DOI: 10.1093/ajh/hpaa169

Graphical Abstract
Graphical Abstract
Abstract
Background
The role of the renin–angiotensin–aldosterone system (RAAS) in coronavirus disease 2019 (COVID-19) is controversially discussed. Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) enters host cells by binding to angiotensin-converting enzyme 2 (ACE2) and activity of the RAAS may affect susceptibility to SARS-CoV-2 infection and outcome of patients with COVID-19.
Methods
In this prospective single-center study, we determined the serum levels of ACE2, angiotensin II, and aldosterone in patients with COVID-19 compared with control patients presenting with similar symptoms in the emergency unit.
Results
We analyzed serum samples from 24 SARS-CoV-2 positive and 61 SARS-CoV-2 negative patients. SARS-CoV-2 positive and control patients did not differ in baseline patients characteristics, symptoms, and clinical presentation. Mean serum concentrations of ACE2, angiotensin II, and aldosterone did not differ between the SARS-CoV-2 positive and the control group. In line with this, serum potassium as surrogate parameter for RAAS activity and blood pressure were similar in both groups.
Conclusions
In summary, we did not find evidence for altered RAAS activity including angiotensin II, aldosterone, or potassium levels, and blood pressure in patients with COVID-19.
Clinical trials registration
Trial Number DRKS00021206.