Extract
Coronavirus disease 2019 (COVID-19) causes persistent endothelial inflammation, lung, cardiovascular, kidney and neurological complications, and thromboembolic phenomena of unclear pathogenesis [1]. Severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2) utilises the catalytic site of full-length membrane-bound angiotensin converting enzyme 2 (ACE2) for host cell entry [2], which is thought to downregulate membrane-bound ACE2, and thus contribute to ongoing inflammation due to loss of a degradative pathway for angiotensin II. In healthy individuals, ACE2 exists primarily in its membrane-bound form with very low levels of the catalytically active ectodomain of ACE2 present in the circulation [3]. However, in patients with cardiovascular disease, there is increased “shedding” of ACE2, and higher circulating levels are associated with downregulation of membrane-bound ACE2 [4].
Abstract
Plasma ACE2 activity is persistently elevated in patients after COVID-19 infection. Larger studies are needed to determine if this identifies people at risk of prolonged illness following COVID-19. https://bit.ly/2XQlrYF
Acknowledgements
We thank the generous participation of the study subjects for providing samples. We thank Adam Wheatley, Jane Batten and Helen Kent for help with the COVID-19 cohort, and Ping Huang and Thomas McConville for assistance with the ACE2 activity assays.
Footnotes
Conflict of interest: S.K. Patel has nothing to disclose.
Conflict of interest: J.A. Juno has nothing to disclose.
Conflict of interest: W.S. Lee has nothing to disclose.
Conflict of interest: K.M. Wragg has nothing to disclose.
Conflict of interest: P.M. Hogarth reports grants from National Health and Medical Research Council (Australia) during the conduct of the study; grants from Genmab (b.v.), outside the submitted work.
Conflict of interest: S.J. Kent has nothing to disclose.
Conflict of interest: L.M. Burrell has nothing to disclose.
Support statement: This study was supported by the Victorian Government (S.J. Kent, J.A. Juno), an Australian government Medical Research Future Fund award GNT2002073 (S.J. Kent, P.M. Hogarth), the ARC Centre of Excellence in Convergent Bio-Nano Science and Technology CE140100036 (S.J. Kent), NHMRC programme grants APP1149990 (S.J. Kent) and APP 1055214 (L.M. Burrell), project grant GNT1145303 (P.M. Hogarth), Medical Research Future Fund award GNT 1175865 (S.K. Patel, L.M. Burrell), Austin Medical Research Foundation Grant (S.K. Patel, L.M. Burrell). J.A. Juno and S.J. Kent are supported by NHMRC fellowships. Funding information for this article has been deposited with the Crossref Funder Registry.
- Received October 6, 2020.
- Accepted January 3, 2021.
- Copyright ©The authors 2021
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