AUTHOR=Camargo Rafael L. , Bombassaro Bruna , Monfort-Pires Milena , Mansour Eli , Palma Andre C. , Ribeiro Luciana C. , Ulaf Raisa G. , Bernardes Ana Flavia , Nunes Thyago A. , Agrela Marcus V. , Dertkigil Rachel P. , Dertkigil Sergio S. , Araujo Eliana P. , Nadruz Wilson , Moretti Maria Luiza , Velloso Licio A. , Sposito Andrei C. TITLE=Plasma Angiotensin II Is Increased in Critical Coronavirus Disease 2019 JOURNAL=Frontiers in Cardiovascular Medicine VOLUME=9 YEAR=2022 URL=https://www.frontiersin.org/journals/cardiovascular-medicine/articles/10.3389/fcvm.2022.847809 DOI=10.3389/fcvm.2022.847809 ISSN=2297-055X ABSTRACT=

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) employs angiotensin-converting enzyme 2 (ACE2) as its receptor for cell entrance, and studies have suggested that upon viral binding, ACE2 catalytic activity could be inhibited; therefore, impacting the regulation of the renin-angiotensin-aldosterone system (RAAS). To date, only few studies have evaluated the impact of SARS-CoV-2 infection on the blood levels of the components of the RAAS. The objective of this study was to determine the blood levels of ACE, ACE2, angiotensin-II, angiotensin (1–7), and angiotensin (1–9) at hospital admission and discharge in a group of patients presenting with severe or critical evolution of coronavirus disease 2019 (COVID-19). We showed that ACE, ACE2, angiotensin (1–7), and angiotensin (1–9) were similar in patients with critical and severe COVID-19. However, at admission, angiotensin-II levels were significantly higher in patients presenting as critical, compared to patients presenting with severe COVID-19. We conclude that blood levels of angiotensin-II are increased in hospitalized patients with COVID-19 presenting the critical outcome of the disease. We propose that early measurement of Ang-II could be a useful biomarker for identifying patients at higher risk for extremely severe progression of the disease.