ArticleInternational journal of infectious diseases : IJID : official publication of the International Society for Infectious Diseases2022
Circulating ACE2 activity predicts mortality and disease severity in hospitalized COVID-19 patients.
Article in International journal of infectious diseases : IJID : official publication of the International Society for Infectious Diseases, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 74 papers.
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Who cites it
74 citing papers in PubMed, 102 citations in OpenAlex.
- Exploratory Analysis of Plasma Angiotensin-Converting Enzyme 2 and Angiotensin Peptides as Candidate Discriminatory Signals in Breast Cancer: A Pilot Case-Control Study.Biomedicines · 2026Article
- Leukocytic ADAM10 and ADAM17 modulate disease severity and systemic outcome in bacterial and viral pneumonia.The European respiratory journal · 2026Article
- Whole-Body Cryotherapy at -90 °C for 9 Weeks: Effects on Immune Function, Stress, and Immune-Related and Vascular Blood Parameters in Healthy Adults-Results of an Exploratory One-Armed Pilot Study.Journal of clinical medicine · 2026Article
- Is long-term disruption of the renin-angiotensin-aldosterone system associated with long COVID? A retrospective cohort study among healthcare workers.BMC infectious diseases · 2026Article
- Elevated ANG2/ACE2 and immune responses associated with Plasmodium falciparum and SARS-CoV-2 coinfection in Cameroon.PLOS global public health · 2026Article
- Mechanisms and impact of long COVID: pathophysiology, neuropsychiatric effects and vaccination.Frontiers in immunology · 2026Review
- Profiling of proteases involved in SARS-CoV-2 pathogenesis in human saliva: Influence of age and gender.Journal, genetic engineering & biotechnology · 2025Article
- Expression of SARS-CoV-2 entry receptor ACE2 in human brain and its association with Alzheimer's disease and COVID-19.Molecular psychiatry · 2025Review
- Genetic and Inflammatory Signatures Associated With Worse Prognosis in Hospitalized Patients With Severe SARS-CoV-2 Infection With and Without Diabetes.Journal of medical virology · 2025Article
- Angiotensin converting enzyme 2 in patients with sepsis associate with comorbidities but neither with mortality nor with organ failure.Scientific reports · 2025Observational
- Integrated renin angiotensin system dysregulation and immune profiles predict COVID-19 disease severity in a South African cohort.Scientific reports · 2025Article
- Prognostic Value of Biomarkers in COVID-19: Associations with Disease Severity, Viral Variants, and Comorbidities-A Retrospective Observational Single-Center Cohort Study.Life (Basel, Switzerland) · 2025Article
- Analysis of Biomarker Levels in Nasopharyngeal Swabs, Serum, and Saliva Across Different Health Conditions.Life (Basel, Switzerland) · 2025Article
- Restoring lung renin-angiotensin system balance through blood pressure control.Clinical science (London, England : 1979) · 2025Article
- Renin-angiotensin-aldosterone system activation in plasma as marker for prognosis in critically ill patients with COVID-19: a prospective exploratory study.Annals of intensive care · 2025Article
- Dual role of ACE2 in regulating inflammation triggered by Omicron S1 and other SARS-CoV-2 Spike variants.Frontiers in immunology · 2025Article
- Plasma Soluble Angiotensin-Converting Enzyme 2 and Risk of Recurrent Stroke: A Nested Case-Control Analysis.Cerebrovascular diseases (Basel, Switzerland) · 2025Article
- Circulating angiotensin-converting enzyme 2 concentration is associated with acute kidney injury and mortality in sepsis.PloS one · 2025Article
- Elevated Soluble ACE2 Activity in Children and Adults After SARS-CoV-2 Exposure Irrespective of Laboratory-Confirmed Infection.Journal of medical virology · 2024Article
- Prognostic Value of Baseline Serum Pro-Inflammatory Cytokines in Severe Multisystem Inflammatory Syndrome in Children.Journal of clinical medicine · 2024Article
14 more citing papers are in PubMed but not listed here.
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Authors and funding
16 authors at 1 institution in 3 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivesAngiotensin-converting enzyme 2 (ACE2) represents the primary receptor for SARS-CoV-2 to enter endothelial cells. Here we investigated circulating ACE2 activity to predict the severity and mortality of COVID-19.
methodsSerum ACE2 activity was measured in COVID-19 (110 critically ill and 66 severely ill subjects at hospital admission and 106 follow-up samples) and in 32 non-COVID-19 severe sepsis patients. Associations between ACE2, inflammation-dependent biomarkers, pre-existing comorbidities, and clinical outcomes were studied.
resultsInitial ACE2 activity was significantly higher in critically ill COVID-19 patients (54.4 [36.7-90.8] mU/L) than in severe COVID-19 (34.5 [25.2-48.7] mU/L; P<0.0001) and non-COVID-19 sepsis patients (40.9 [21.4-65.7] mU/L; P=0.0260) regardless of comorbidities. Circulating ACE2 activity correlated with inflammatory biomarkers and was further elevated during the hospital stay in critically ill patients. Based on ROC-curve analysis and logistic regression test, baseline ACE2 independently indicated the severity of COVID-19 with an AUC value of 0.701 (95% CI [0.621-0.781], P<0.0001). Furthermore, non-survivors showed higher serum ACE2 activity vs. survivors at hospital admission (P<0.0001). Finally, high ACE2 activity (≥45.4 mU/L) predicted a higher risk (65 vs. 37%) for 30-day mortality (Log-Rank P<0.0001).
conclusionsSerum ACE2 activity correlates with COVID-19 severity and predicts mortality.
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