Angiotensin-Converting Enzyme (ACE) level, but not ACE gene polymorphism, is associated with prognosis of COVID-19 infection: Implications for diabetes and hypertension

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dc.authoridYilmaz Duzgun, Ipek/0000-0003-3182-8268
dc.authoridapaydin, tugce/0000-0001-9277-8669
dc.authoridElbasan, Onur/0000-0001-8580-9471
dc.authoridBayram Catak, Feyza/0000-0002-7484-4383
dc.authoridKarimi, Nastaran/0000-0002-9827-6974
dc.contributor.authorElbasan, Onur
dc.contributor.authorBayram, Feyza
dc.contributor.authorYazan, Ceyda Dincer
dc.contributor.authorApaydin, Tugce
dc.contributor.authorDashdamirova, Saida
dc.contributor.authorPolat, Hamza
dc.contributor.authorArslan, Ebru
dc.date.accessioned2025-03-23T19:30:32Z
dc.date.available2025-03-23T19:30:32Z
dc.date.issued2023
dc.departmentSinop Üniversitesi
dc.description.abstractBackgroundThe renin-angiotensin-aldosterone system was shown to be activated in severe COVID-19 infection. We aimed to investigate the relationship between angiotensin converting enzyme (ACE) levels, ACE gene polymorphism, type 2 diabetes (T2DM), and hypertension (HT) and the prognosis of COVID-19 infection. MethodsThis cross-sectional study analyzed the clinical features of adult patients with SARS-CoV-2 infection. ACE gene analysis and ACE level measurements were performed. The patients were grouped according to ACE gene polymorphism (DD, ID or II), disease severity (mild, moderate, or severe), and the use of dipeptidyl peptidase-4 enzyme inhibitor (DPP4i), ACE-inhibitor (ACEi) or angiotensin receptor blocker (ARB). Intensive care unit (ICU) admissions and mortality were also recorded. ResultsA total of 266 patients were enrolled. Gene analysis detected DD polymorphism in the ACE 1 gene in 32.7% (n = 87), ID in 51.5% (n = 137), and II in 15.8% (n = 42) of the patients. ACE gene polymorphisms were not associated with disease severity, ICU admission, or mortality. ACE levels were higher in patients who died (p = 0.004) or were admitted to the ICU (p<0.001) and in those with severe disease compared to cases with mild (p = 0.023) or moderate (p<0.001) disease. HT, T2DM, and ACEi/ARB or DPP4i use were not associated with mortality or ICU admission. ACE levels were similar in patients with or without HT (p = 0.374) and with HT using or not using ACEi/ARB (p = 0.999). They were also similar in patients with and without T2DM (p = 0.062) and in those with and without DPP4i treatment (p = 0.427). ACE level was a weak predictor of mortality but an important predictor of ICU admission. It predicted ICU admission in total (cutoff value >37.092 ng/mL, AUC: 0.775, p<0.001). ConclusionOur findings suggest that higher ACE levels, but not ACE gene polymorphism, ACEi/ARB or DPP4i use, were associated with the prognosis of COVID-19 infection. The presence of HT and T2DM and ACEi/ARB or DPP4i use were not associated with mortality or ICU admission.
dc.identifier.doi10.1371/journal.pone.0288338
dc.identifier.issn1932-6203
dc.identifier.issue7
dc.identifier.pmid37432962
dc.identifier.scopusqualityQ1
dc.identifier.urihttps://doi.org/10.1371/journal.pone.0288338
dc.identifier.urihttps://hdl.handle.net/11486/5097
dc.identifier.volume18
dc.identifier.wosWOS:001054197500016
dc.identifier.wosqualityQ1
dc.indekslendigikaynakWeb of Science
dc.indekslendigikaynakPubMed
dc.language.isoen
dc.publisherPublic Library Science
dc.relation.ispartofPlos One
dc.relation.publicationcategoryMakale - Uluslararası Hakemli Dergi - Kurum Öğretim Elemanı
dc.rightsinfo:eu-repo/semantics/openAccess
dc.snmzKA_WOS_20250323
dc.subjectInsertion/Deletion Polymorphism
dc.subjectFunctional Receptor
dc.subjectSeverity
dc.subjectCoronavirus
dc.subjectMortality
dc.subjectDisease
dc.subjectInhibitors
dc.subjectMellitus
dc.titleAngiotensin-Converting Enzyme (ACE) level, but not ACE gene polymorphism, is associated with prognosis of COVID-19 infection: Implications for diabetes and hypertension
dc.typeArticle

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