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SARS-CoV-2 proteins

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    Angiotensin-(3-4) modulates angiotensin converting enzyme 2 (ACE2) downregulation in proximal tubule cells due to overweight and undernutrition: implications regarding the severity of renal lesions in Covid-19 MESHD infection

    Authors: Rafael Luzes; Humberto Muzi-Filho; Amaury Pereira-Acacio; Thuany Crisostomo; Adalberto Vieyra

    doi:10.1101/2020.06.29.178293 Date: 2020-06-29 Source: bioRxiv

    The renal lesions – including severe acute kidney injury MESHD – are severe outcomes in SARS-CoV-2 infections MESHD. There are no reports regarding the influence of the nutritional status on the severity and progress of these lesions. Ageing is also an important risk factor. In the present communication we compare the influence of overweight and undernutrition in the levels of renal angiotensin converting enzymes 1 and 2. Since the renin-angiotensin-aldosterone system ( RAAS MESHD) has been implicated in the progress of kidney failure MESHD during Covid-19 MESHD, we also investigated the influence of Angiotensin-(3–4) (Ang-(3–4)) the shortest angiotensin-derived peptide, which is considered the physiological antagonist of several angiotensin II effects. We found that both overweight and undernutrition downregulate the levels of angiotensin converting enzyme 2 (ACE2) without influence on the levels of ACE1 in kidney rats. Administration of Ang-(3–4) recovers the control levels of ACE2 in overweight but not in undernourished rats. We conclude that chronic and opposite nutritional conditions play a central role in the pathophysiology of renal Covid-19 MESHD lesions, and that the role of RAAS is also different in overweight and undernutrition.Competing Interest StatementThe authors have declared no competing interest.View Full Text

    Early prediction for severe COVID-19 MESHD with hypertension and intervention

    Authors: Denggao Peng; Yanzhang Gao; Zhenyu Zhou; Huan Wang; Anjue Tang

    doi:10.21203/rs.3.rs-31888/v1 Date: 2020-05-28 Source: ResearchSquare

    Background To identify the early predictors of severe coronavirus disease 2019 MESHD ( COVID-19 MESHD) with hypertension MESHD,explore antihypertensive drugs with potential therapeutic effects, and provide a basis for clinical prediction and treatment decisions.Method: A retrospective study was performed on all included cases.Results A total of 68 COVID-19 MESHD patients with hypertension MESHD were included,27 (39.7%) was severe and 41 (60.3%) was non-severe. Between the non-severe group (n = 41) and the severe group (n = 27),number of elevated B-type natriuretic peptide ( BNP HGNC) and abnormal renal function MESHD,and albumin,lactate dehydrogenase,ultrasensitive troponin I,PH Value,arterial carbon dioxide partial pressure,sodium,osmotic pressure (OP),blood sugar (BS) and oxygenation index (OI) are significantly different.While age, male gender,comorbidities with diabetes MESHD or atherosclerotic cardiovascular disease MESHD,smoking history,number of abnormal liver function MESHD,heart rate,respiratory rate, blood pressure,white blood cell count,hematocrit,potassium and lactic acid are statistically insignificant.Four independent predictors of BNP HGNC (P = .026),OP (P = .004),BS (P = .017) and OI (P = .001) are obtained through multivariate binary logistic regression model.The area under curve (AUC) of receiver operating characteristic (ROC) of model is 0.904 ([95%CI] [0.832–0.976];P = .000),with excellent performance.Compared with blank control group (n = 27) and other antihypertensive drugs group (n = 20),OP ([287.3 ± 5.7] vs [283.5 ± 6.1];P = .045) ([287.3 ± 5.7] vs [281.9 ± 5.4];P = .007) in renin HGNC-angiotensin-aldosterone system (RAS) inhibitors group (n = 21) have increased significantly.Compared with controlled blood pressure group (n = 30),OP ([285.7 ± 6.2] vs [282.2 ± 5.2];P = .012) of uncontrolled group (n = 38) increased significantly.Conclusion Decreased OP MESHD and OI, increased BNP HGNC and BS are early predictors for severe COVID-19 MESHD patients with hypertension MESHD.For poorly controlled blood pressure,targeting RAS MESHD and OP,early use of RAS inhibitors or combination with loop diuretics may be an effective treatment.

    Hypertension and Renin HGNC-Angiotensin-Aldosterone System Inhibitors in Patients with Covid-19 MESHD

    Authors: Andrew Ip; Kaushal Parikh; Joseph E Parrillo; Shivam Mathura; Eric Hansen; Ihor S Sawczuk; Stuart L Goldberg

    doi:10.1101/2020.04.24.20077388 Date: 2020-04-29 Source: medRxiv

    Introduction: COVID-19 MESHD disproportionately affects those with comorbidities and the elderly. Hypertension MESHD is the most common pre-existing condition amongst COVID-19 MESHD patients. Upregulation of the renin HGNC-angiotensin-aldosterone system ( RAAS MESHD) is common in hypertensive MESHD patients and may promote inflammation MESHD and ensuing cytokine storm in COVID-19 MESHD. It is unknown whether RAAS inhibition with ACE1 HGNC inhibitors or angiotensin-receptor blockers (ARB) can be harmful or beneficial. Methods: Within Hackensack Meridian Health network, the largest healthcare provider in New Jersey, we performed a retrospective, multicenter, convenience sampling study of hospitalized COVID-19 MESHD patients. Demographics, clinical characteristics, treatments, and outcomes were manually abstracted. Fishers exact tests, and logistic regression were performed. Results: Among 3017 hospitalized COVID-19 MESHD patients, 1584 (52.5%) carried a diagnosis of hypertension MESHD. In the discharged or deceased cohort, the overall mortality was significantly increased at 35% vs 13% among COVID-19 MESHD patients with hypertension MESHD. However, when adjusted for age, the effect of hypertension MESHD on mortality was greatly diminished, with a reduction in odds-ratio by over half; and completely disappeared when adjusted for other major covariates. The mortality rates were lower for hypertensive MESHD patients prescribed ACE1 HGNC (27%, p=0.001) or ARBs (33%, p=0.12) compared to other anti- hypertensive MESHD agents (39%) in the unadjusted analyses. RAAS inhibitor therapy appeared protective compared to other anti- hypertensive MESHD agents (p=0.001). Conclusions: While our results are limited by the retrospective nature of our study and by potential confounders, our data argue against a harmful effect of RAAS inhibition and support the HFSA/AHA/ACC joint statement recommending continuing ACE1 HGNC and ARB therapy in hypertensive MESHD COVID-19 MESHD patients.

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MeSH Disease
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SARS-CoV-2 Proteins


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