Efficacy of Serum Angiotensin II Levels in Prognosis of Patients With Coronavirus Disease 2019

OBJECTIVES: We aimed to determine serum angiotensin II levels in patients with coronavirus disease 2019 infection and to investigate the effect of these levels on the prognosis of the disease. DESIGN: The study was planned prospectively and observationally. SETTING: The study was conducted in a tertiary university hospital. PATIENTS: Coronavirus disease 2019 patients older than 18 years old, polymerase chain reaction test positive, with signs of pneumonia on tomography, and hospitalized were included in the study. ICU need, development of acute respiratory distress syndrome, and in-hospital mortality were considered as primary endpoints. INTERVENTIONS: Blood samples were taken from patients three times for angiotensin II levels. MEASUREMENTS AND MAIN RESULTS: Angiotensin II levels were studied by enzyme-linked immunosorbent assay method. The SPSS 24.0 program (Statistics Program for Social Scientists, SPSS, Chicago, IL) was used to analyze the data. A total of 112 patients were included in the study, of which 63.4% of the patients were men. The serum angiotensin II levels were statistically significantly lower in the patients with coronavirus disease 2019 compared with the healthy control group (p < 0.001). There was no statistical significance between the serum angiotensin II levels measured at three different times (p > 0.05). The serum angiotensin II levels of the patients with acute respiratory distress syndrome were found to be statistically significantly lower than those without acute respiratory distress syndrome in three samples collected at different clinical periods (p < 0.05). The angiotensin II levels of the patients who required admission to the ICU at all three times of blood sample collection were found to be statistically significantly lower than those who did not (p < 0.05). Although the serum angiotensin II levels of the patients who died were low, there was no statistically significant difference in mortality at all three times (p > 0.05). CONCLUSIONS: The serum angiotensin II levels decrease significantly in patients with coronavirus disease 2019, and this decrease is correlated with lung damage.

Automated summary

The study aimed to determine serum angiotensin II levels in patients with COVID-19 and investigate its effect on disease prognosis. Results showed significantly lower angiotensin II levels in COVID-19 patients compared to healthy controls, with lower levels observed in patients with acute respiratory distress syndrome and those requiring ICU admission. Although low angiotensin II levels were linked to lung damage, they did not significantly correlate with mortality.