在接受不同抗高血压药物治疗的高血压COVID-19患者中，可溶性血管紧张素转换酶2（ACE2）和血管紧张素II水平受到调节。
Soluble ACE2 and angiotensin II levels are modulated in hypertensive COVID-19 patients treated with different antihypertension drugs.
作者信息
A Elrayess Mohamed, T Zedan Hadeel, A Alattar Rand, Abusriwil Hatem, Al-Ruweidi Mahmoud Khatib A A, Almuraikhy Shamma, Parengal Jabeed, Alhariri Bassem, Yassine Hadi M, A Hssain Ali, Nair Arun, Al Samawi Musaed, Abdelmajid Alaaeldin, Al Suwaidi Jassim, Omar Saad Mohamed, Al-Maslamani Muna, Omrani Ali S, Yalcin Huseyin C
机构信息
Biomedical Research Center, Qatar University, Doha, Qatar.
Department of Biomedical Science, College of Health Sciences, Member of QU Health, Qatar University, Doha, Qatar.
出版信息
Blood Press. 2022 Dec;31(1):80-90. doi: 10.1080/08037051.2022.2055530.
PURPOSE
This study examines the effect of antihypertensive drugs on ACE2 and Angiotensin II levels in hypertensive COVID-19 patients.
INTRODUCTION
Hypertension is a common comorbidity among severe COVID-19 patients. ACE2 expression can be modulated by antihypertensive drugs such as ACEis and ARBs, which may affect COVID-19's prognosis. BB and CCB reduce mortality, according to some evidence. Their effect on circulating levels of ACE2 and angiotensin II, as well as the severity of COVID-19, is less well studied.
MATERIALS AND METHODS
The clinical data were collected from 200 patients in four different antihypertensive medication classes (ACEi, ARB, BB, and CCB). Angiotensin II and ACE2 levels were determined using standard ELISA kits. ACE2, angiotensin II, and other clinical indices were evaluated by linear regression models.
RESULTS
Patients on ACEi ( = 57), ARB ( = 68), BB ( = 15), or CCB ( = 30) in this study had mild ( = 76), moderate ( = 76), or severe ( = 52) COVID-19. ACE2 levels were higher in COVID-19 patients with severe disease ( = 0.04) than mild ( = 0.07) and moderate ( = 0.007). The length of hospital stay is correlated with ACE2 levels ( = 0.3, = 0.003). Angiotensin II levels decreased with severity ( = 0.04). Higher ACE2 levels are associated with higher CRP and D-dimer levels. Elevated Angiotensin II was associated with low levels of CRP, D-dimer, and troponin. ACE2 levels increase with disease severity in patients taking an ARB ( = 0.01), patients taking ACEi, the degree of disease severity was associated with a decrease in angiotensin II. BB patients had the lowest disease severity.
CONCLUSION
We found different levels of soluble ACE2, and angiotensin II are observed among COVID-19 patients taking different antihypertensive medications and exhibiting varying levels of disease severity. COVID-19 severity increases with elevated ACE2 levels and lower angiotensin II levels indicating that BB treatment reduces severity regardless of levels of ACE2 and angiotensin II.
目的
本研究探讨抗高血压药物对高血压合并新冠病毒病（COVID-19）患者血管紧张素转换酶2（ACE2）和血管紧张素II水平的影响。
引言
高血压是重症COVID-19患者常见的合并症。ACE2表达可受ACE抑制剂（ACEis）和血管紧张素II受体阻滞剂（ARBs）等抗高血压药物调节，这可能影响COVID-19的预后。一些证据表明，β受体阻滞剂（BB）和钙通道阻滞剂（CCB）可降低死亡率。它们对ACE2和血管紧张素II循环水平以及COVID-19严重程度的影响研究较少。
材料与方法
收集了200例服用四种不同抗高血压药物（ACEi、ARB、BB和CCB）患者的临床资料。使用标准酶联免疫吸附测定（ELISA）试剂盒测定血管紧张素II和ACE2水平。通过线性回归模型评估ACE2、血管紧张素II和其他临床指标。
结果
本研究中服用ACEi（n = 57）、ARB（n = 68）、BB（n = 15）或CCB（n = 30）的患者患有轻度（n = 76）、中度（n = 76）或重度（n = 52）COVID-19。重症COVID-19患者（P = 0.04）的ACE2水平高于轻症（P = 0.07）和中症患者（P = 0.007）。住院时间与ACE2水平相关（r = 0.3，P = 0.003）。血管紧张素II水平随疾病严重程度降低（P = 0.04）。较高的ACE2水平与较高的C反应蛋白（CRP）和D-二聚体水平相关。血管紧张素II升高与CRP、D-二聚体和肌钙蛋白水平降低相关。服用ARB的患者（P = 0.01）中，ACE2水平随疾病严重程度增加，服用ACEi的患者中，疾病严重程度与血管紧张素II降低相关。服用BB的患者疾病严重程度最低。
结论
我们发现，在服用不同抗高血压药物且疾病严重程度不同的COVID-19患者中观察到可溶性ACE2和血管紧张素II水平存在差异。COVID-19严重程度随ACE2水平升高和血管紧张素II水平降低而增加，这表明无论ACE2和血管紧张素II水平如何，BB治疗均可降低严重程度。
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