A prediction model for lung involvement using circulating angiotensin converting enzyme-2 and renin levels in COVID-19 patients

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dc.authorid0009-0000-0930-0278
dc.contributor.authorAkkan, Cansu
dc.contributor.authorDas, Murat
dc.contributor.authorBardakci, Okan
dc.contributor.authorSehitoglu, Muserref Hilal
dc.contributor.authorAkdur, Gokhan
dc.contributor.authorAkman, Canan
dc.contributor.authorAkdur, Okhan
dc.date.accessioned2026-02-03T11:59:46Z
dc.date.available2026-02-03T11:59:46Z
dc.date.issued2025
dc.departmentÇanakkale Onsekiz Mart Üniversitesi
dc.description.abstractIntroduction: The potential role of the renin-angiotensin-aldosterone system (RAAS) in the pathogenesis of coronavirus disease 2019 (COVID-19) is controversial, with concerns mainly about the part RAAS peptides play in the prediction of progression to more severe disease. Given the importance of COVID-19 prognostication at early disease stages, we established and validated a multivariable risk stratification tool for COVID-19 associated lung involvement by utilizing a combination of RAAS peptides. Methodology: In this prospective study, circulating renin and angiotensin converting enzyme-2 (ACE-2) levels were measured in 116 COVID-19 patients who were admitted to our hospital from March 30, 2021 to January 24, 2022 and underwent a lung computed tomography (CT) scan. Clinical severity was measured with a national early warning score (NEWS). Associations among RAAS peptides, inflammation-dependent biomarkers, demographic variables, and clinical outcomes were studied using logistic regression and Cox proportional-hazards models. Results: We assessed 116 COVID-19 patients (mean age 45.1 f 12.6 years; 51.7% male), of whom 66 (56.9%) had COVID-19 associated pneumonia. Baseline circulating ACE-2 (2.63 f 0.12 ng/mL) and renin levels (85.04 f 6.8 ng/L) were lower in patients with COVID-19 related pneumonia compared to patients without pneumonia (6.4 f 0.7 ng/mL and 211.6 f 21.9 ng/L, respectively) (p < 0.001 for both). Both RAAS components were found to be significantly related to adverse outcomes, including COVID-19 associated pneumonia and intensive care unit (ICU) admission, in both crude and adjusted multivariable logistic regression analyses. Conclusions: Circulating ACE-2 and renin levels can predict lung involvement in COVID-19 patients, and they display good correlation and agreement with NEWS.
dc.description.sponsorshipScientific Research Projects Coordination Unit of Canakkale Onsekiz Mart University [TTU-2021-3685]
dc.description.sponsorshipThis research is supported by The Scientific Research Projects Coordination Unit of Canakkale Onsekiz Mart University (Project ID: TTU-2021-3685) .
dc.identifier.doi10.3855/jidc.21313
dc.identifier.endpage1442
dc.identifier.issn1972-2680
dc.identifier.issue10
dc.identifier.pmid41187182
dc.identifier.scopus2-s2.0-105020894403
dc.identifier.scopusqualityQ3
dc.identifier.startpage1432
dc.identifier.urihttps://doi.org/10.3855/jidc.21313
dc.identifier.urihttps://hdl.handle.net/20.500.12428/34414
dc.identifier.volume19
dc.identifier.wosWOS:001650744100001
dc.identifier.wosqualityQ4
dc.indekslendigikaynakWeb of Science
dc.indekslendigikaynakScopus
dc.indekslendigikaynakPubMed
dc.language.isoen
dc.publisherJ Infection Developing Countries
dc.relation.ispartofJournal of Infection in Developing Countries
dc.relation.publicationcategoryMakale - Uluslararası Hakemli Dergi - Kurum Öğretim Elemanı
dc.rightsinfo:eu-repo/semantics/openAccess
dc.snmzKA_WOS_20260130
dc.subjectACE-2
dc.subjectCOVID-19
dc.subjectemergency medicine
dc.subjectNEWS
dc.subjectpneumonia
dc.subjectrenin
dc.titleA prediction model for lung involvement using circulating angiotensin converting enzyme-2 and renin levels in COVID-19 patients
dc.typeArticle

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