Lack of Correlation Between Soluble Angiotensin-Converting Enzyme 2 and Inflammatory Markers in Hospitalized COVID-19 Patients with Hypertension

Figures & data

Table 1 Patients’ Characteristics (N = 40) Upon Hospital Admission

Patients’ Characteristics	Patients Treated with RAAS Inhibitors (n=25)	Patients Treated with Non-RAAS Inhibitors (n=15)	Total (N=40)
Age (years), mean ± SD	58.08 ± 12.81	55.9 ± 10.65	57.3 ± 11.93
Sex, n (%)
Male	20 (50)	6	26 (65)
Female	5 (12.5)	9	14 (35)
SBP (mmHg), mean ± SD	139 ± 10.6	138 ± 11.5	138 ± 11.5
DBP (mmHg), mean ± SD	87 ± 8.7	87 ± 8.7	87 ± 8.7
BMI (kg/m^2), mean ± SD	25.5 ± 1.87	24.7 ± 3.02	25.2 ± 2.38
COVID-19 disease severity, n (%)
Mild	12 (30)	11 (27.5)	23 (57.5)
Moderate	13 (32.5)	4 (20)	17 (42.5)
Clinical symptoms at admission, n (%)
Fever	20 (50)	8 (20)	28 (70)
Cough	20 (50)	15 (37.5)	35 (87.5)
Dyspnea	8 (20)	4 (10)	12 (30)
Fatigue	4 (10)	6 (15)	10 (25)
Anosmia	6 (15)	4 (10)	10 (25)
Low SaO2 (≤95%)	5 (12.5)	4 (10)	9 (22.5)
Comorbidities, n (%)
Diabetes Mellitus	4 (10)	2 (5)	6 (15)
Asthma	1 (2.5)	1 (2.5)	2 (5)
Types of antihypertensive(s), n (%)
RAAS inhibitors only	6 (15)	0 (0)	6 (15)
CCB only	0 (0)	15 (37.5)	15 (37.5)
RAAS inhibitors + CCB	19 (47.5)	0 (0)	19 (47.5)
Duration of antihypertensive medication, n (%)
≤ 1 year	2 (5)	0 (0)	2 (5)
> 1 year	23 (57.5)	15 (37.5)	38 (95)
Concomitant medications, n (%)
Statins	4 (10)	1 (2.5)	5 (7.5)
Metformin	4 (10)	0 (0)	4 (10)
Clopidogrel	1 (2.5)	1 (2.5)	2 (5)
No concomitant meds	18 (45)	13 (32.5)	31 (77.5)
Duration of hospitalization, days	11.6 ± 4.5	11.9 ± 4.8	11.7 ± 4.6
Outcomes, n
Deaths	0 (0)	0 (0)	0 (0)
Clinical cure	25 (62.5)	15 (37.5)	40 (100)

Abbreviations: RAAS, renin angiotensin aldosterone system; CCB, calcium channel blockers.

Table 2 Correlation Analysis Between sACE2 Inflammatory and Coagulation Markers

Markers of Interests		p-value	Spearman’s rho	95% Confidence Intervals
sACE2	hs-CRP	0.367	0.147	−0.182–0.446
	TNF-α	0.625	0.800	−0.247–0.390
	IL-6	0.106	0.259	−0.066–0.535
	IL-10	0.969	0.006	−0.247–0.390
	IL-6/IL-10	0.432	0.128	−0.200–0.430
	IFN-γ	0.139	0.238	−0.089–0.519
	Neutrophile to lymphocyte ratio (NLR)	0.909	0.022	−0.341–0.379
	D-dimer	0.988	0.003	−0.395–0.400

Abbreviations: sACE2, soluble angiotensin-converting enzyme 2; hs-CRP, high-sensitivity C-reactive protein; TNF-α, tumor necrosis factor-α; IL-6, interleukin-6; IL-10, interleukin-10; IFN-γ, interferon-γ.

Table 3 Soluble ACE2 and Inflammation, Coagulation, and Hematology Markers in COVID-19 Hypertensive Patients Given RAAS-Inhibitors and Non-RAAS Inhibitors

Variables	RAAS-Inhibitor, n=25, Mean (SD)	Non-RAAS Inhibitor, n=15, Mean (SD)	p-value^#
sACE2, ng/mL	2.8 (1.55)	3.6 (0.86)	0.0426*
hsCRP, mg/L	4.6 (6.19)	4.6 (4.50)	NS
TNF-α, pg/mL	13.3 (6.20)	13.8 (3.78)	NS
IFN-γ, pg/mL	3.2 (3.75)	2.3 (2.18)	NS
IL-6, pg/mL	12.5 (36.27)	6.8 (10.01)	NS
IL-10, pg/mL	2.7 (4.62)	0.9 (1.98)	0.0233*
IL-6/IL-10 ratio	4.8 (4.47)	15.4 (15.93)	0.0234*
D-dimer, mg/mL	1.1 (1.83)	0.9 (1.58)	NS
Hemoglobin, g/dL	14.2 (1.58)	13.8 (1.25)	NS
Hematocrits, %	39.5 (4.26)	39.9 (3.15)	NS
Neutrophils, %	63.3 (12.71)	58.9 (22.40)	NS
Lymphocytes, %	23.9 (9.44)	24.8 (15.07)	NS
Platelets, per μL	234 400 (81,510)	296 300 (87,440)	NS
NLR	3.4 (2.23)	3.9 (4.31)	NS
Urea, mg/dL	39.60 (17.54)	23.40 (8.11)	0.0096*
Creatinine, mg/dL	1.20 (0.39)	0.80 (0.20)	0.0224*
AST, IU/L	34.2 (15.02)	33.1 (15.83)	NS
ALT, IU/L	34.7 (19.74)	38.2 (23.95)	NS
AST/ALT ratio	1.1 (0.32)	1.0 (0.39)	NS

Notes: The bold value indicates a significant difference between RAAS-inhibitors vs non-RAAS-inhibitor (p < 0.05). ^#Calculated with Welch’s unpaired t-test; *Significant at p < 0.05; NS = not significant (p > 0.05).

Abbreviations: sACE2, soluble angiotensin-converting enzyme 2; hs-CRP, high sensitivity C-reactive protein; TNF-α, tumor necrosis factor-α; IL-6, interleukin-6; IL-10, interleukin-10; IFN-γ, interferon-γ; NLR, neutrophil to lymphocyte ratio.