We use cookies to understand how you use our site and to improve your experience. This includes personalizing content and advertising. To learn more, click here. By continuing to use our site, you accept our use of cookies. Cookie Policy.

Features Partner Sites Information LinkXpress
Sign In
Advertise with Us
Technopath Clinical Diagnostics - An LGC Company


BMG LABTECH is a manufacturer of a wide range of dedicated and multi-mode microplate instruments ranging from single-... read more Featured Products: More products

Download Mobile App


ATTENTION: Due to the COVID-19 PANDEMIC, many events are being rescheduled for a later date, converted into virtual venues, or altogether cancelled. Please check with the event organizer or website prior to planning for any forthcoming event.

Circulating ACE2 Activity Predicts Mortality and Severity in COVID-19 Patients

By LabMedica International staff writers
Posted on 16 Dec 2021
Print article
Image: The CLARIOstar Plus is a multi-mode microplate reader with advanced LVF Monochromators, highly sensitive filters, and an ultra-fast UV/vis spectrometer (Photo courtesy of BMG Labtech)
Image: The CLARIOstar Plus is a multi-mode microplate reader with advanced LVF Monochromators, highly sensitive filters, and an ultra-fast UV/vis spectrometer (Photo courtesy of BMG Labtech)
Coronavirus disease 2019 (COVID-19) has been associated with significant morbidity and mortality worldwide in the last two years. This disease is caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection.

Angiotensin-converting enzyme 2 (ACE2) represents the main receptor for SARS-CoV-2 to enter endothelial cells. ACE2 mediates the infection of endothelial cells, which induces endothelial activation and damage resulting in substantial release of von Willebrand factor and enhanced levels of soluble E-selectin.

Medical Laboratorians at the University of Debrecen (Debrecen, Hungary) recruited for a retrospective clinical study, 176 consecutive COVID-19 patients older than 18 years of age from two medical centers. These subjects suffered from different degrees of acute respiratory distress at admission and were confirmed to be positive for COVID-19 disease by reverse transcription polymerase chain reaction (RT-qPCR) test of a nasopharyngeal swab.

Two-thirds of these patients had a positive hemoculture (e.g. Escherichia coli, Klebsiella pneumoniae, Enterococcus faecalis, or Streptococcus pneumoniae), while the rest of individuals were culture-negative. All subjects had peripheral blood samples drawn at admission, and follow-up samples were also available before discharge or death in case of 106 subjects. The analysis of serum ACE2 activity was performed by a specific quenched fluorescent substrate (Peptide2, Chantilly, VA, USA). The cleavage of the quenched Mca-APK(Dnp) to liberate the fluorescent K(Dnp) was recorded using 340-nm excitation and 405-nm emission filters in a CLARIOstar microplate reader (BMG Labtech, Ortenberg, Germany).

Routinely available laboratory serum tests (i.e. CRP, PCT, IL-6, cTnT and ferritin) were determined by electro-chemiluminescent immunoassays on a Cobas e 411 analyzer, while enzyme activities (i.e. AST, ALT, LDH) and creatinine with urea levels were analyzed by kinetic colorimetric assays on a Cobas 8000 analyzer (Roche Diagnostics, Mannheim, Germany).

The investigators reported that initial ACE2 activity was significantly higher in critically ill COVID-19 patients (54.4 [36.7-90.8] mU/L) than in severe COVID-19 (34.5 [25.2-48.7] mU/L) and non-COVID-19 sepsis patients (40.9 [21.4-65.7] mU/L) regardless of comorbidities. Further, there was a tendency for higher ACE2 activity in relation to increasing age regardless of disease severity. Circulating ACE2 activity correlated with inflammatory biomarkers and was further elevated during hospital stay in critically ill patients. Based on ROC-curve analysis and logistic regression test, baseline ACE2 independently indicated the severity of COVID-19 with an AUC value of 0.701. Overall, non-survivors demonstrated significantly higher ACE2 activities (54.6 [IQR 37.3-94.7] mU/L) at hospital admission compared with survivors (35.6 [25.3-58.5] mU/L).

Miklós Fagyas, MD, PhD, an assistant professor and lead author of the study, said, “Serum ACE2 activity at hospital admission correlates with COVID-19 severity and predicts mortality, independently of the pulmonary function (Horowitz index). It appears that serum ACE2 is a non-specific biomarker in systemic inflammation, since it is also elevated in severe sepsis.” The study was published on November 25, 2021 in the International Journal of Infectious Diseases.

Related Links:
University of Debrecen
BMG Labtech
Roche Diagnostics

Gold Supplier
Automatic Biochemistry Analyzer
Biossays C8
SARS-CoV-2 IgG Antibodies Anti-S1 Assay
iRapid SARS-CoV-2 Quant "Neutralizing" Ab
Automated Nucleic Acid Extraction System
Silver Supplier
3-Part Hematology Analyzer

Print article


Clinical Chem.

view channel
Image: The analysis pipeline used to investigate associations between blood metabolites, later life brain imaging measures, and genetic risk for Alzheimer’s disease (Photo courtesy of University College London)

Lipid Measurements Show Potential as Alzheimer’s Disease Biomarkers

Brain changes accompanying ageing are varied and can include pathologies that lead to cognitive impairment, the commonest of which is Alzheimer’s disease (AD). Identifying blood-based signatures of brain... Read more

Molecular Diagnostics

view channel
Image: This image depicts a DNA molecule that is methylated on both strands on the center cytosine. DNA methylation plays an important role for epigenetic gene regulation in development and cancer (Photo courtesy of Wikimedia Commons)

Study Supports Use of Methylated DNA Biomarkers for Cancer Diagnosis and Prognosis

A recent study added weight to the theory that methylated DNA biomarkers could be used for cancer diagnosis and prognosis. Methylation is a biological process by which methyl groups are added to a DNA molecule.... Read more


view channel
Image: Standard test for multiple myeloma provides clues of a rare, more deadly type (Photo courtesy of Pexels)

Standard Blood Cancer Test Provides Clues of Rare IgD Multiple Myeloma

IgD myeloma accounts for about 1% of common blood cancer multiple myeloma and has a worse prognosis. Specific testing for IgD myeloma is available at a handful of reference labs across the US, but takes... Read more


view channel
Image: QIAGEN has acquired a majority stake in enzymes provider BLIRT S.A. (Photo courtesy of QIAGEN)

Qiagen Acquires Enzymes Provider Blirt to Strengthen Sample Technologies Business

QIAGEN N.V. (Venlo, Netherlands) has signed agreements to acquire a 96% majority ownership stake in BLIRT S.A. (Gdansk, Poland), a manufacturer of recombinant enzymes for the life science industry.... Read more
Copyright © 2000-2022 Globetech Media. All rights reserved.