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Soluble Angiotensin-Converting Enzyme 2 as a Prognostic Biomarker for Disease Progression in Patients Infected with SARS-CoV-2

Predicting disease severity in patients infected with SARS-CoV-2 is difficult. Soluble angiotensin-converting enzyme 2 (sACE2) arises from the shedding of membrane ACE2 (mACE2), which is a receptor for SARS-CoV-2 spike protein. We evaluated the predictive value of sACE2 compared with known biomarker...

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Autores principales: Díaz-Troyano, Noelia, Gabriel-Medina, Pablo, Weber, Stephen, Klammer, Martin, Barquín-DelPino, Raquel, Castillo-Ribelles, Laura, Esteban, Angels, Hernández-González, Manuel, Ferrer-Costa, Roser, Pumarola, Tomas, Rodríguez-Frías, Francisco
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9031748/
https://www.ncbi.nlm.nih.gov/pubmed/35453934
http://dx.doi.org/10.3390/diagnostics12040886
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author Díaz-Troyano, Noelia
Gabriel-Medina, Pablo
Weber, Stephen
Klammer, Martin
Barquín-DelPino, Raquel
Castillo-Ribelles, Laura
Esteban, Angels
Hernández-González, Manuel
Ferrer-Costa, Roser
Pumarola, Tomas
Rodríguez-Frías, Francisco
author_facet Díaz-Troyano, Noelia
Gabriel-Medina, Pablo
Weber, Stephen
Klammer, Martin
Barquín-DelPino, Raquel
Castillo-Ribelles, Laura
Esteban, Angels
Hernández-González, Manuel
Ferrer-Costa, Roser
Pumarola, Tomas
Rodríguez-Frías, Francisco
author_sort Díaz-Troyano, Noelia
collection PubMed
description Predicting disease severity in patients infected with SARS-CoV-2 is difficult. Soluble angiotensin-converting enzyme 2 (sACE2) arises from the shedding of membrane ACE2 (mACE2), which is a receptor for SARS-CoV-2 spike protein. We evaluated the predictive value of sACE2 compared with known biomarkers of inflammation and tissue damage (CRP, GDF-15, IL-6, and sFlt-1) in 850 patients with and without SARS-CoV-2 with different clinical outcomes. For univariate analyses, median differences between biomarker levels were calculated for the following patient groups (classified by clinical outcome): RT-PCR-confirmed SARS-CoV-2 positive (Groups 1–4); RT-PCR-confirmed SARS-CoV-2 negative following previous SARS-CoV-2 infection (Groups 5 and 6); and ‘SARS-CoV-2 unexposed’ patients (Group 7). Median levels of CRP, GDF-15, IL-6, and sFlt-1 were significantly higher in hospitalized patients with SARS-CoV-2 compared with discharged patients (all p < 0.001), whereas levels of sACE2 were significantly lower (p < 0.001). ROC curve analysis of sACE2 provided cut-offs for predicting hospital admission (≤0.05 ng/mL (positive predictive value: 89.1%) and ≥0.42 ng/mL (negative predictive value: 84.0%)). These findings support further investigation of sACE2, as a single biomarker or as part of a panel, to predict hospitalization risk and disease severity in patients with SARS-CoV-2 infection.
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spelling pubmed-90317482022-04-23 Soluble Angiotensin-Converting Enzyme 2 as a Prognostic Biomarker for Disease Progression in Patients Infected with SARS-CoV-2 Díaz-Troyano, Noelia Gabriel-Medina, Pablo Weber, Stephen Klammer, Martin Barquín-DelPino, Raquel Castillo-Ribelles, Laura Esteban, Angels Hernández-González, Manuel Ferrer-Costa, Roser Pumarola, Tomas Rodríguez-Frías, Francisco Diagnostics (Basel) Article Predicting disease severity in patients infected with SARS-CoV-2 is difficult. Soluble angiotensin-converting enzyme 2 (sACE2) arises from the shedding of membrane ACE2 (mACE2), which is a receptor for SARS-CoV-2 spike protein. We evaluated the predictive value of sACE2 compared with known biomarkers of inflammation and tissue damage (CRP, GDF-15, IL-6, and sFlt-1) in 850 patients with and without SARS-CoV-2 with different clinical outcomes. For univariate analyses, median differences between biomarker levels were calculated for the following patient groups (classified by clinical outcome): RT-PCR-confirmed SARS-CoV-2 positive (Groups 1–4); RT-PCR-confirmed SARS-CoV-2 negative following previous SARS-CoV-2 infection (Groups 5 and 6); and ‘SARS-CoV-2 unexposed’ patients (Group 7). Median levels of CRP, GDF-15, IL-6, and sFlt-1 were significantly higher in hospitalized patients with SARS-CoV-2 compared with discharged patients (all p < 0.001), whereas levels of sACE2 were significantly lower (p < 0.001). ROC curve analysis of sACE2 provided cut-offs for predicting hospital admission (≤0.05 ng/mL (positive predictive value: 89.1%) and ≥0.42 ng/mL (negative predictive value: 84.0%)). These findings support further investigation of sACE2, as a single biomarker or as part of a panel, to predict hospitalization risk and disease severity in patients with SARS-CoV-2 infection. MDPI 2022-04-01 /pmc/articles/PMC9031748/ /pubmed/35453934 http://dx.doi.org/10.3390/diagnostics12040886 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Díaz-Troyano, Noelia
Gabriel-Medina, Pablo
Weber, Stephen
Klammer, Martin
Barquín-DelPino, Raquel
Castillo-Ribelles, Laura
Esteban, Angels
Hernández-González, Manuel
Ferrer-Costa, Roser
Pumarola, Tomas
Rodríguez-Frías, Francisco
Soluble Angiotensin-Converting Enzyme 2 as a Prognostic Biomarker for Disease Progression in Patients Infected with SARS-CoV-2
title Soluble Angiotensin-Converting Enzyme 2 as a Prognostic Biomarker for Disease Progression in Patients Infected with SARS-CoV-2
title_full Soluble Angiotensin-Converting Enzyme 2 as a Prognostic Biomarker for Disease Progression in Patients Infected with SARS-CoV-2
title_fullStr Soluble Angiotensin-Converting Enzyme 2 as a Prognostic Biomarker for Disease Progression in Patients Infected with SARS-CoV-2
title_full_unstemmed Soluble Angiotensin-Converting Enzyme 2 as a Prognostic Biomarker for Disease Progression in Patients Infected with SARS-CoV-2
title_short Soluble Angiotensin-Converting Enzyme 2 as a Prognostic Biomarker for Disease Progression in Patients Infected with SARS-CoV-2
title_sort soluble angiotensin-converting enzyme 2 as a prognostic biomarker for disease progression in patients infected with sars-cov-2
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9031748/
https://www.ncbi.nlm.nih.gov/pubmed/35453934
http://dx.doi.org/10.3390/diagnostics12040886
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