Preprint Article Version 1 Preserved in Portico This version is not peer-reviewed

Increased Angiotensin-Converting Enzyme 2, sRAGE and iMmune Activation, but Lowered Calcium and Magnesium In COVID-19: Association With Chest CT Abnormalities and Lowered Peripheral Oxygen Saturation

Version 1 : Received: 26 March 2021 / Approved: 29 March 2021 / Online: 29 March 2021 (17:03:46 CEST)

How to cite: Al-Hakeim, H.; Al-Jassas, H.; Morris, G.; Maes, M. Increased Angiotensin-Converting Enzyme 2, sRAGE and iMmune Activation, but Lowered Calcium and Magnesium In COVID-19: Association With Chest CT Abnormalities and Lowered Peripheral Oxygen Saturation. Preprints 2021, 2021030710 (doi: 10.20944/preprints202103.0710.v1). Al-Hakeim, H.; Al-Jassas, H.; Morris, G.; Maes, M. Increased Angiotensin-Converting Enzyme 2, sRAGE and iMmune Activation, but Lowered Calcium and Magnesium In COVID-19: Association With Chest CT Abnormalities and Lowered Peripheral Oxygen Saturation. Preprints 2021, 2021030710 (doi: 10.20944/preprints202103.0710.v1).

Abstract

Background. The characterization of new biomarkers of COVID-19 is extremely important. Few studies measured the soluble receptor for advanced glycation end product (sRAGE), angiotensin-converting enzyme 2 (ACE2), calcium and magnesium in COVID-19. Aims: To measure sRAGE, ACE2, interleukin (IL)-6, IL-10, CRP, calcium, magnesium, and albumin in COVID-19 patients in association with peripheral oxygen saturation (SpO2) and chest CT scan abnormalities (CCTA) including ground glass opacities. Methods. This study measured sRAGE, ACE2, IL-6, IL-10, CRP using ELISA techniques, and calcium, magnesium, and albumin using a spectrophotometric method in 60 COVID-19 patients and 30 healthy controls.Results. COVID-19 is characterized by significantly increased IL-6, CRP, IL-10, sRAGE, ACE2, and lowered levels of SpO2, albumin, magnesium and calcium. Neural networks showed that a combination of calcium, IL-6, CRP, and sRAGE yielded an accuracy of 100% in detecting COVID-19 patients with calcium being the most important predictor followed by IL-6, and CRP. COVID-19 patients with CCTAs showed lower SpO2 and albumin levels than those without CCTAs. SpO2 was significantly and inversely correlated with IL-6, IL-10, CRP, sRAGE, and ACE2, and positively with albumin, magnesium and calcium. Patients with positive IgG results showed a significant elevation in the serum level of IL-6, sRAGE, and ACE2 compared to the negatively IgG patient subgroup.Conclusion. The results show that immune-inflammatory and RAGE pathway biomarkers may be used as external validating criterion for the diagnosis COVID-19. Those pathways coupled with lowered SpO2, calcium and magnesium are drug targets that may help to reduce the consequences of COVID-19.

Subject Areas

COVID-19; sRAGE; ACE2; inflammation; immune; oxidative stress; IL-6; IL-10; biomarkers

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