Changes in the SARS-CoV-2 cellular receptor ACE2 levels in cardiovascular patients: a potential biomarker for the stratification of COVID-19 patients

Fagyas, Miklós; Bánhegyi, Viktor; Katalin, Úri; Enyedi, Ágnes; Lizanecz, Erzsébet; Mányiné, Ivetta Siket; Mártha, Lilla; Fülöp, Gábor; Radovits, Tamás; Pólos, Miklós; Merkely, Béla; Kov́acs, Árṕad; Szilvássy, Zoltán; Ungvári, Zoltán; Édes, István; Csanádi, Zoltán; Boczán, Judit; Takács, Ildikó; Szabó, Gábor; Balla, József; Balla, György; Seferović, Petar; Papp, Zoltán; Tóth, Attila

doi:10.1007/s11357-021-00467-2

Cited by 16 publications

(12 citation statements)

References 48 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In patients with comorbidities that affect the microvasculature or the myocardium, COVID-19-related vascular and myocardial pathologies can be exacerbated. Furthermore, both aging and several comorbidities were shown to increase the expression of the cellular entry receptors of SARS-CoV-2, which directly affect the severity of COVID-19 [49][50][51][52]. A possible entry receptor of COVID-19 could also be the adipokine enzyme DPP4 [53].…”

Section: Discussionmentioning

confidence: 99%

Comorbidities and increased mortality of COVID-19 among the elderly: A systematic review

Péterfi

Mészáros

Szarvas

et al. 2022

PhysInt

View full text Add to dashboard Cite

Purpose The purpose of current review is to conduct a systematic overview of articles published between 2019 and 2021 on the relationship of comorbidities and mortality due to Coronavirus Disease 2019 (COVID-19) among the elderly population. Methods We conducted a systematic search on PubMed for articles published between 2019 and 2021 to identify any cohort and case-control studies that investigated the relationship of comorbidities and COVID-19 mortality among the elderly, defined as 60 years of age and above. Databases were searched independently by two authors. Disagreements were resolved by the inclusion of a third investigator. Reviews, systematic reviews, and meta-analyses were excluded from our systematic review. Results A total of 15 studies were selected for our systematic review. Of the included studies, 3 were case-control, 3 were prospective cohort studies and 9 were retrospective cohort studies. As for size, 10 studies were conducted on populations of <1000 participants, 3 ranging from 1001 to 10,000, and 2 on populations of >10,000 individuals. The included studies found that the presence of certain conditions, such as cardiovascular, respiratory, renal diseases, malignancies, diseases of the nervous system and diabetes are associated to increased mortality in populations that consisted of elderly patients. Conclusion Results of our systematic review suggest that comorbidities contribute to increased COVID-19 mortality among the elderly. The detrimental effect of comorbidities and advanced age on the immune response could lead to a more frequent occurrence of symptomatic and severe infections with COVID-19.

show abstract

Section: Discussionmentioning

confidence: 99%

Comorbidities and increased mortality of COVID-19 among the elderly: A systematic review

Péterfi

Mészáros

Szarvas

et al. 2022

PhysInt

View full text Add to dashboard Cite

show abstract

“…Recruiting COVID-19 patients was approved under the registration number 32568-32020EÜIG [ 11 ]⁠. Recruiting patients with heart failure with dilated cardiomyopathy [ 12 ]⁠ or with aortic stenosis [ 13 ]⁠ was approved under the registration identifier UDCC RECIEC 4375–2015. The human heart samples used for the identification of the autoantibodies were collected and banked under the cover of an ethical permit issued by the Hungarian Ministry of Health (323–82,005-1018EKU).…”

Section: Methodsmentioning

confidence: 99%

The majority of severe COVID-19 patients develop anti-cardiac autoantibodies

et al. 2022

Self Cite

View full text Add to dashboard Cite

Severe cases of COVID-19 are characterized by an inflammatory burst, which is accompanied by multiorgan failure. The elderly population has higher risk for severe or fatal outcome for COVID-19. Inflammatory mediators facilitate the immune system to combat viral infection by producing antibodies against viral antigens. Several studies reported that the pro-inflammatory state and tissue damage in COVID-19 also promotes autoimmunity by autoantibody generation. We hypothesized that a subset of these autoantibodies targets cardiac antigens. Here we aimed to detect anti-cardiac autoantibodies in severe COVID-19 patients during hospitalization. For this purpose, 104 COVID-19 patients were recruited, while 40 heart failure patients with dilated cardiomyopathy and 20 patients with severe aortic stenosis served as controls. Patients were tested for anti-cardiac autoantibodies, using human heart homogenate as a bait. Follow-up samples were available in 29 COVID-19 patients. Anti-cardiac autoantibodies were detected in 68% (71 out of 104) of severe COVID-19 patients. Overall, 39% of COVID-19 patients had anti-cardiac IgG autoantibodies, while 51% had anti-cardiac autoantibodies of IgM isotype. Both IgG and IgM anti-cardiac autoantibodies were observed in 22% of cases, and multiple cardiac antigens were targeted in 38% of COVID-19 patients. These anti-cardiac autoantibodies targeted a diverse set of myocardial proteins, without apparent selectivity. As controls, heart failure patients (with dilated cardiomyopathy) had similar occurrence of IgG (45%, p = 0.57) autoantibodies, while significantly lower occurrence of IgM autoantibodies (30%, p = 0.03). Patients with advanced aortic stenosis had significantly lower number of both IgG (11%, p = 0.03) and IgM (10%, p < 0.01) type anti-cardiac autoantibodies than that in COVID-19 patients. Furthermore, we detected changes in the anti-cardiac autoantibody profile in 7 COVID-19 patients during hospital treatment. Surprisingly, the presence of these anti-cardiac autoantibodies did not affect the clinical outcome and the prevalence of the autoantibodies did not differ between the elderly (over 65 years) and the patients younger than 65 years of age. Our results demonstrate that the majority of hospitalized COVID-19 patients produce novel anti-cardiac IgM autoantibodies. COVID-19 also reactivates resident IgG autoantibodies. These autoantibodies may promote autoimmune reactions, which can complicate post-COVID recuperation, contributing to post-acute sequelae of COVID-19 (long COVID). Supplementary Information The online version contains supplementary material available at 10.1007/s11357-022-00649-6.

show abstract

“…It has also been shown that COVID-19 can affect individuals in all age groups, yet it mostly causes severe disease in older adults. The mechanisms by which aging exacerbate the severity of COVID-19 include age-related immunosenescence, aging-induced impairment of organismal and cellular stress resilience and a greater prevalence of comorbidities in older adults [2,[12][13][14][15][16][17][18][19][20][21][22][23][24]. COPD patients who are former smokers tend to exhibit the highest mortality associated with COVID-19 infection [15][16][17].…”

Section: Copd Exacerbates Severity Of Covid-19mentioning

confidence: 99%

“…On the basis of the available evidence it can be hypothesized that changes in the expression of ACE-2 play an important role in increased susceptibility to severe COVID-19 infection. ACE-2 is implicated in the entry of the virus into the host's airway epithelium to establish an active infection [18,19]. A recent clinical trial was conducted to explore the association between ACE-2 expression and COVID-19 mortality in COPD patients [20].…”

Section: Copd Cigarette Smoking and Ace-2 Expressionmentioning

confidence: 99%

COVID-19 infection in patients with chronic obstructive pulmonary disease: From pathophysiology to therapy. Mini-review

Fekete

Szarvas

Fazekas-Pongor

et al. 2022

PhysInt

View full text Add to dashboard Cite

Introduction Patients with chronic obstructive pulmonary disease (COPD) are a vulnerable group in terms of the outcome of coronavirus infection in relation to their disease or its treatment, with a higher risk of developing serious complications compared to the healthy population. Aim The aim of our summary study is to review the background and health outcomes of chronic obstructive pulmonary disease and COVID-19 infection in the presence of both diseases. Methods Review of national and international medical databases (PubMed, MEDLINE, and MOB) with keywords COPD, COVID-19, disease risk, cause, prevention, complications, and prognosis. Results Meta-analyses show that COPD is one of the most common underlying conditions in patients hospitalized for COVID-19. Such patients are five times more likely to develop a serious complication due to oxygen supply problems therefore they are more likely to be admitted to intensive care units, where they may require mechanical ventilation. In the case of underlying COPD, the usual care plan for COVID-19 infection should be followed, as well as all public health recommendations to minimize the risk of developing and transmitting COVID-19. Conclusion Coronavirus infection is especially dangerous for COPD patients, who are much more likely to become seriously ill, so increased surveillance, prevention, early detection, adequate treatment and rehabilitation of the disease group are of paramount importance.

show abstract

Changes in the SARS-CoV-2 cellular receptor ACE2 levels in cardiovascular patients: a potential biomarker for the stratification of COVID-19 patients

Cited by 16 publications

References 48 publications

Comorbidities and increased mortality of COVID-19 among the elderly: A systematic review

Comorbidities and increased mortality of COVID-19 among the elderly: A systematic review

The majority of severe COVID-19 patients develop anti-cardiac autoantibodies

COVID-19 infection in patients with chronic obstructive pulmonary disease: From pathophysiology to therapy. Mini-review

Contact Info

Product

Resources

About