High Concentration of ACE2 in the Blood Linked With Risk of Severe COVID-19

Killian Meara

Killian Meara, assistant editor for ContagionLive, joined the MJH Life Sciences team in November 2020. He graduated from William Paterson University with a degree in liberal studies, and concentrations in history and psychology. He enjoys film, reading, and pretending he is a good cook. Follow him on Twitter @krmeara or email him at [email protected]

High admission plasma ACE2 was associated with an increased maximal illness severity within 28 days.

A recent analysis conducted by investigators from Aarhus University in Denmark has discovered that high concentrations of the ACE2 enzyme in the blood may potentially increase an individual’s risk for developing a more severe form of COVID-19.

Results from the analysis were published in the journal PLOS ONE.

"We know that there is a correlation between ACE1 and ACE2," Tue Wenzel Kragstrup, lead author on the analysis said. "If our findings can be recreated by measuring ACE1, this can be used in the clinical work right away."

For the analysis, the team of investigators analyzed data from a large longitudinal study that included 306 patients who tested positive for an infection with COVID-19 and 78 patients who tested negative for the disease.

Samples taken from the patients were run on the Olink Explore 1536 platform that includes a measurement of the ACE2 protein. The platform is based on Proximity Extension Assay (PEA) technology.

"I discovered that Massachusetts General Hospital in Boston, USA, had published a huge amount of data and analyses on their website of 306 patients with COVID-19, together with data and analyses from 78 patients who had tested negative for COVID-19.” Kragstrup said. “The information is encrypted so that it's not possible to identify individuals, but the cohort of patients were followed for 28 days, so you can see what happened to them.”

Findings from the analysis showed that patients with high admission plasma ACE2 in their blood had an increased maximal illness severity within 28 days. Findings also demonstrated that Plasma ACE2 was significantly higher in COVID-19 patients with hypertension compared with patients without hypertension.

Additionally, circulating levels of ACE2 was also significantly higher in COVID-19 patients with pre-existing heart conditions and kidney disease compared to patients without these pre-existing conditions.

"We're familiar with a heightened concentration of ACE2 in connection with cardiovascular diseases, but the concentration is not, for example, higher in connection with diabetes, which we can also see in our study,” Kragstrup said. “But we now hope that ACE2 can help explain excess mortality from COVID-19."