Why the study?
The study investigated the correlation between plasma sACE2 and inflammatory markers in hospitalized COVID-19 patients with hypertension, and evaluated the effects of RAAS inhibitors on these markers.
Do RAAS inhibitors affect sACE2 and inflammatory marker levels compared to non-RAAS inhibitors in hospitalized COVID-19 patients with hypertension?
Do RAAS inhibitors affect sACE2 and inflammatory marker levels compared to non-RAAS inhibitors in hospitalized COVID-19 patients with hypertension?
In hospitalized COVID-19 patients with hypertension, RAAS inhibitors are associated with lower sACE2 and IL-6/IL-10 ratios compared to non-RAAS inhibitors, while maintaining a neutral effect on clinical disease severity and outcomes.
No support for sACE2-guided RAAS changes in hypertensive COVID-19; leaves open biomarker and pathway questions.
Purpose: This study aimed to investigate the correlation of plasma soluble angiotensin-converting enzyme 2, sACE2, and several inflammatory markers in COVID-19 patients requiring hospitalization with hypertension. Additionally, we analyzed the effects of renin-angiotensin-aldosterone-system, RAAS, inhibitors on the levels of sACE2 and inflammatory marker levels in patients with COVID-19. Patients and Methods: This cross-sectional study involved patients with COVID-19 who required hospitalization on a stable dose of antihypertensive drugs. The study included three hospitals in Jakarta and Tangerang, Indonesia, between December 2020 and June 2021. We classified eligible subjects into two groups: patients with COVID-19 treated with antihypertensive RAAS inhibitors or non-RAAS inhibitors. Results: We found no correlation between sACE2 and all the inflammatory and coagulation markers studied (high-sensitivity C-reactive protein, IL-6, IL-10, IL6/IL10, tumor necrosis factor-α, neutrophil-to-lymphocyte ratio, and D-dimer) in COVID-19 patients with hypertension. Further analysis showed lower sACE2 concentrations and IL-6/IL-10 ratio in patients treated with RAAS inhibitors vs those treated with non-RAAS inhibitors. Conclusion: We found no correlation between ACE2 and inflammatory markers. Using RAAS inhibitors resulted in a lower sACE2 and IL-6/IL-10 ratio. The type of antihypertensive treatments has a neutral effect on disease severity and outcome in COVID-19 patients with hypertension. However, to firmly-established these effects, our findings should be confirmed in a much larger population.
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Louisa et al. (2022) studied this question.
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