Does the Serum Concentration of Angiotensin II Type 1 Receptor Have an Effect on the Severity of COVID-19? A Prospective Preliminary Observational Study among Healthcare Professionals

Abstract

SARS-CoV-2 is a virus that causes severe respiratory distress syndrome. The pathophysiology of COVID-19 is related to the renin–angiotensin system (RAS). SARS-CoV-2, a vector of COVID-19, uses angiotensin-converting enzyme 2 (ACE-2), which is highly expressed in human lung tissue, nasal cavity, and oral mucosa, to gain access into human cells. After entering the cell, SARS-CoV-2 inhibits ACE-2, thus favouring the ACE/Ang II/angiotensin II type 1 receptor (AT1R) axis, which plays a role in the development of acute lung injury (ALI). This study aimed to analyse the influence of angiotensin 1 receptor (AT1R) levels in the serum on the course of the severity of symptoms in healthcare professionals who had a SARS-CoV-2 infection. This prospective observational study was conducted on a group of 82 participants. The study group included physicians and nurses who had a COVID-19 infection confirmed by real-time reverse transcription-polymerase chain reaction (RT-PCR) test for SARS-CoV-2. The control group consisted of healthy medical professionals who had not had a SARS-CoV-2 infection or who had no symptoms of COVID-19 and who tested negative for SARS-CoV-2 on the day of examination. We analysed the correlation between AT1R concentration and the severity of COVID-19, as well as with sex, age, blood group, and comorbidities. There were no statistically significant differences in the mean values of AT1R concentration in the recovered individuals and the non-COVID-19 subjects (3.29 vs. 3.76 ng/mL; p = 0.32). The ROC curve for the AT1R assay showed an optimal cut-off point of 1.33 (AUC = 0.44; 95% CI = 0.32–0.57; p = 0.37). There was also no correlation between AT1R concentration and the severity of symptoms associated with COVID-19. Blood type analysis showed statistically significantly lower levels of AT1R in COVID-19-recovered participants with blood group A than in those with blood group O. In conclusion, AT1R concentration does not affect the severity of symptoms associated with COVID-19 among healthcare professionals.

Gene Therapy for Hypertension, Atherosclerosis, and Familial Hypercholesterolemia: The Old Concepts and the New Era

“…AngII has many cellular actions via two receptors, the angiotensin I receptor (AT1R) and the angiotensin II receptor (AT2R) [23]. The linkage of AngII with AT1R results in constriction, inflammation, and fibrosis of peripheral vessel walls, while the linkage with AT2R vasodilates and promotes anti-fibrotic and anti-inflammatory actions [24]. The genetic pathways for the production of AT1R and AT2R have been studied as targets for genetic therapy for EH [25].…”

Updates in Management of SARS-CoV-2 Infection

“…Due to the fact that SARS-CoV-2 uses angiotensin-converting enzyme 2 (ACE-2) as a receptor enabling human infection, research has been undertaken on a possible relationship between angiotensin 1 receptor (AT1R) levels in the serum and the course of the disease. However, Janc et al [ 16 ] did not show the effect of AT1R on the severity of symptoms associated with COVID-19 among healthcare professionals and any prognostic significance. On the other hand, San-Cristobal et al [ 17 ], based on the analysis of clinical and biochemical variables obtained in the first 72 h of hospitalization from 1039 COVID-19 patients, specified three clusters with different clinical severity outcomes.…”

Presença dos vírus SARS-CoV-2 na cavidade oral e suas manifestações orais: uma avaliação biomolecular e imuno-histoquímica de casos fatais de COVID-19

“…Ainda não há tantos estudos realizados que investigam a presença do receptor ACE2 na cavidade oral. Embora a distribuição do receptor em outras áreas do trato gastrointestinal sugira uma alta presença, como mencionado anteriormente, a disponibilidade de dados é limitada [33]. Análises de mRNA em tecidos normais de uma pequena amostra de pesquisa demonstraram a presença do receptor na cavidade oral, mas em menor número do que em outros órgãos alvo, como pulmões, rins, coração e esôfago [34].…”