Lack of Correlation Between Soluble Angiotensin-Converting Enzyme 2 and Inflammatory Markers in Hospitalized COVID-19 Patients with Hypertension

• Published in: Infection and drug resistance 2022-01, Vol.15, p.4799-4807
• Main Authors: Louisa, Melva, Cahyadi, Daniel, Nilasari, Dina, Soetikno, Vivian
• Format: Article
• Language: English
• Subjects: ACE inhibitors; ACE2; Aldosterone; Analysis; Angiotensin; Angiotensin-converting enzyme 2; Antihypertensive drugs; Antihypertensives; C-reactive protein; Care and treatment; Clinical outcomes; Coronaviruses; COVID-19; Cytokine storm; cytokines; Diagnosis; Disease; Drug dosages; Enzymes; Hematology; Hypertension; Inflammation; Interleukin 10; Interleukin 6; Interleukins; Leukocytes (neutrophilic); Lymphocytes; Medical research; Medicine, Experimental; neutrophil-to-lymphocyte ratio; Original Research; Patients; Peptidyl-dipeptidase A; Plasma; Renin; renin-angiotensin-aldosterone system inhibitors; Severe acute respiratory syndrome coronavirus 2; Tumor necrosis factor-α; Viral infections
• ISSN: 1178-6973; 1178-6973
• DOI: 10.2147/IDR.S369771

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-a, 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. Keywords: antihypertensive drugs, cytokines, interleukins, neutrophil-to-lymphocyte ratio, renin-angiotensin- aldosterone system inhibitors