No increased activity of the renin-angiotensin-aldosterone system in patients with COVID-19

The role of the renin-angiotensin-aldosterone system in the corona virus-induced disease COVID-19 is controversially discussed. SARS-CoV-2 enters host cells by binding to angiotensin-converting enzyme 2 and activity of the renin-angiotensin-aldosterone system may affect susceptibility to SARS-CoV-2 infection and outcome of patients with COVID-19. In this study, we determined the serum levels of ACE-2, angiotensin II and aldosterone in patients with COVID-19 compared to control patients .

In a prospective single-center registry supported by the German Center for Infection Research we analyzed serum samples from patients with suspected COVID-19 in the emergency unit. SARS-CoV-2 positive and control patients were similar in baseline patients characteristics, symptoms and clinical presentation. Mean serum concentrations of ACE2, angiotensin II, and aldosterone did not differ between the SARS-CoV-2 positive and the control group. In line with this, serum potassium as surrogate parameter for RAAS activity and blood pressure were similar in both groups.

Rieder et al. Serum ACE-2, angiotensin II, and aldosterone levels are unchanged in patients with COVID-19. Am J Hypertension 2020; doi:https://doi.org/10.1093/ajh/hpaa169

See also:
Commentary by Wenzel & Kintscher. ACE2 and SARS-CoV-2 – tissue or plasma, good or bad? Am J Hypertension 2020
Letter by Rojas et al. How important is the assessment of soluble ACE-2 in COVID-19? Am J Hypertension 2020
Rieder et al. Response to: How important is the assessment of soluble ACE-2 in COVID-19? Am J Hypertension 2020