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October 12, 2022European Journal of Clinical InvestigationOpen Access

Total ACE2 expression was elevated in subjects with various diseases compared to healthy controls (SMD 0.13), with subgroup analyses showing significant increases in membrane-bound ACE2 in cardiovascular and viral diseases.

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Why the study?

ACE2 is a key receptor for SARS-CoV2 and maintains cardiovascular homeostasis, but ACE2 expressions and their modulation in healthy and disease states remained to be explored.

Does ACE2 expression differ in patients with COVID-19, cardiovascular disease, and other diseases compared to healthy subjects?

Population

39 studies of patients with SARS-CoV2, CVD, diabetes, kidney disorders, pulmonary disease, or viral infections

Comparison

Patients with COVID-19 or various diseases vs healthy controls

Design

Systematic review and meta-analysis

Key result

Total ACE2 expression was elevated in subjects with various diseases compared to healthy controls (SMD 0.13), with subgroup analyses showing significant increases in membrane-bound ACE2 in cardiovascular and viral diseases.

Authors

DKDipanjali KamtheSSSwapnil Dilip SarangkarMDManali Suresh Dalvi

Discussion

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Member takes

Overview

Elevated membrane-bound ACE2 in cardiovascular disease may increase SARS-CoV-2 susceptibility; extends observational evidence and warrants prospective validation before clinical translation.

Study Design

Type

Meta-Analysis (n=7,726)

Structured PICO

Does ACE2 expression differ in patients with COVID-19, cardiovascular disease, and other diseases compared to healthy subjects?

P
Population
7,726 subjects (4,686 with various diseases including COVID-19, CVD, and diabetes, and 3,040 healthy controls) from 39 studies evaluating ACE2 expression levels.
E
Exposure
Presence of disease (COVID-19, cardiovascular disease, diabetes, kidney disorders, pulmonary diseases, or other viral infections)
C
Comparator
Healthy subjects
O
Outcome
ACE2 expression levels (soluble and membrane-bound)surrogate

Main Result

Standardized Mean Difference: 0.13 (95% CI -0.02–0.29)

p-value: p=0.10

Membrane-bound ACE2 expression is significantly elevated in patients with cardiovascular disease and viral infections, which may have implications for SARS-CoV-2 susceptibility and pathophysiology.

Limitations

  • Diverse methods employed for the estimation of ACE2 levels across included studies
  • ACE2 expressions were analyzed at both transcriptional and translational levels
  • Samples taken for expression studies were diverse in origin

Cite This Study

Kamthe et al. (2022) conducted a meta-analysis in COVID-19, Cardiovascular diseases, Diabetes, Pulmonary diseases, Kidney disorders, Viral infections (n=7,726). Disease state (COVID-19, CVD, diabetes, etc.) vs. Healthy subjects was evaluated on Total ACE2 expression in all diseases vs. healthy subjects (SMD 0.13, 95% CI -0.02-0.29, p=0.10). Total ACE2 expression was elevated in subjects with various diseases compared to healthy controls (SMD 0.13), with subgroup analyses showing significant increases in membrane-bound ACE2 in cardiovascular and viral diseases.

synapsesocial.com/papers/6a9b194eebbd1a612aacae9ehttps://doi.org/10.1111/eci.13891
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Also Consider

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

  1. 1Twenty years of progress in angiotensin converting enzyme 2 and its link to SARS-CoV-2 disease2020 · 15 citations
  2. 2Regulation of Angiotensin-Converting Enzyme 2: A Potential Target to Prevent COVID-19?2021 · 22 citations
  3. 3ACE/ACE2 axis in cardiovascular disease and COVID-19: Molecular insights and therapeutic perspectives2026
  4. 4The Role of Soluble ACE2 as a Prognostic Marker in Severe COVID-19: A Brief Meta-Analysis2022 · 5 citations
  5. 5Role of Angiotensin Converting Enzyme-2 and its modulation in disease: exploring new frontiers2023 · 5 citations