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November 30, 2021Hypertension

An upward trajectory of soluble ACE2 at repeat sampling (7 days) was independently associated with an elevated risk of mortality and incidence of acute myocardial injury and circulatory shock.

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Why the study?

Pathological ADAM17 activation may promote inflammation and diminish ACE2 tissue protection through proteolytic shedding, prompting examination of plasma soluble ACE2 and angiotensin profiles in relation to COVID-19 outcomes.

Is an upward trajectory of soluble ACE2 associated with increased 90-day mortality and end-organ injury in patients admitted for COVID-19?

Population

242 consecutive patients admitted for COVID-19

Comparison

Baseline vs repeated plasma soluble ACE2 and angiotensin profiles at 7 days

Design

Prospective cohort study

Follow-up

90 days

Discussion

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Member takes

Overview

Rising soluble ACE2 trajectories flag higher COVID-19 mortality risk; leaves open whether ADAM17-targeted interventions warrant trials.

Structured PICO

Is an upward trajectory of soluble ACE2 associated with increased 90-day mortality and end-organ injury in patients admitted for COVID-19?

P
Population
242 consecutive patients admitted for COVID-19, median age 63 (52-74) years, 155 (64.0%) men.
O
Outcome
90-day mortalityhard clinical

An upward trajectory of soluble ACE2 and dysregulation of angiotensin peptides are associated with increased mortality and end-organ injury in COVID-19 patients.

Cite This Study

A 2021 study studied this question.

synapsesocial.com/papers/6a925cfe5ab1441fe3c813f0https://doi.org/10.1161/hypertensionaha.121.18295
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Abstract P130: Higher Circulating Angiotensin Converting Enzyme 2 (ACE2) and ACE2 to ACE Ratio Are Associated With Lower COVID-19 Mortality: A Mechanistic Substudy of the ACTIV-4 Host Tissue Trials2024 · 1 citations
  2. 2Plasma ACE and ACE2 Levels Are Altered in Patients with COVID-192026
  3. 3Expression of ACE2, Soluble ACE2, Angiotensin I, Angiotensin II and Angiotensin-(1-7) Is Modulated in COVID-19 Patients2021 · 105 citations
  4. 4ADAM-17 Activity and Its Relation to ACE2: Implications for Severe COVID-192024 · 4 citations
  5. 5A Low Aldosterone/Renin Ratio and High Soluble ACE2 Associate with COVID-19 Severity2021