Kidney Week

Abstract: TH-PO1135

Circulating ACE2 Activity and Gas6 Are Increased in Patients Diagnosed with COVID-19

Session Information

• COVID-19
  October 24, 2024 | Location: Exhibit Hall, Convention Center
  Abstract Time: 10:00 AM - 12:00 PM

Category: Coronavirus (COVID-19)

• 000 Coronavirus (COVID-19)

Authors

• Martínez Díaz, Irene, Vall d’Hebron Institut de Recerca (VHIR), Vall d’Hebron Hospital Universitari, Vall d’Hebron Barcelona Hospital Campus, . Nephrology and Transplantation Research Group, Barcelona, Spain

Irene Martínez Díaz

• Vergara, Ander, Vall d’Hebron Institut de Recerca (VHIR), Vall d’Hebron Hospital Universitari, Vall d’Hebron Barcelona Hospital Campus, . Nephrology and Transplantation Research Group, Barcelona, Spain

Ander Vergara, MD, PhD

• Cano Camara, Antonio, Vall d’Hebron Institut de Recerca (VHIR), Vall d’Hebron Hospital Universitari, Vall d’Hebron Barcelona Hospital Campus, . Nephrology and Transplantation Research Group, Barcelona, Spain

Antonio Cano Camara

• Ortiz Pérez, José Tomás, Department of Cardiology, Cardiovascular Institute, Hospital Clínic de Barcelona, Fundació Clinic per la Recerca Biomédica, Universitat de Barcelona, Barcelona, Spain

José Tomás Ortiz Pérez, MD, PhD

• Fernandez Diaz, Adria, Department of Cardiology, Cardiovascular Institute, Hospital Clínic de Barcelona, Fundació Clinic per la Recerca Biomédica, Universitat de Barcelona, Barcelona, Spain

Adria Fernandez Diaz

• Llorens Cebrià, Carmen, Vall d’Hebron Institut de Recerca (VHIR), Vall d’Hebron Hospital Universitari, Vall d’Hebron Barcelona Hospital Campus, . Nephrology and Transplantation Research Group, Barcelona, Spain

Carmen Llorens Cebrià, MS

• Nunez-Delgado, Sara, Vall d’Hebron Institut de Recerca (VHIR), Vall d’Hebron Hospital Universitari, Vall d’Hebron Barcelona Hospital Campus, . Nephrology and Transplantation Research Group, Barcelona, Spain

Sara Nunez-Delgado, MD

• Vilardell, Jordi, Vall d’Hebron Institut de Recerca (VHIR), Vall d’Hebron Hospital Universitari, Vall d’Hebron Barcelona Hospital Campus, . Nephrology and Transplantation Research Group, Barcelona, Spain

Jordi Vilardell, PhD

• García de Frutos, Pablo, Instituto de Investigaciones Biomédicas de Barcelona (IIBB)-Consejo Superior de Investigaciones Científicas (CSIC), Barcelona, Spain

Pablo García de Frutos, PhD

• Morales, Albert, Instituto de Investigaciones Biomédicas de Barcelona (IIBB)-Consejo Superior de Investigaciones Científicas (CSIC), Barcelona, Spain

Albert Morales, PhD

• Jacobs Cachá, Conxita, Vall d’Hebron Institut de Recerca (VHIR), Vall d’Hebron Hospital Universitari, Vall d’Hebron Barcelona Hospital Campus, . Nephrology and Transplantation Research Group, Barcelona, Spain

Conxita Jacobs Cachá, PhD

• Soler, Maria Jose, Vall d’Hebron Institut de Recerca (VHIR), Vall d’Hebron Hospital Universitari, Vall d’Hebron Barcelona Hospital Campus, . Nephrology and Transplantation Research Group, Barcelona, Spain

Maria Jose Soler, MD, PhD

Group or Team Name

• Nephrology and Transplantation Group.

Background

The angiotensin converting enzyme 2 (ACE2) is the cell entry receptor for SARS-CoV-2. SARS-CoV2 participates in ACE2 shedding from cell membrane, increasing soluble ACE2. ACE2 has been shown to cooperate with the receptor AXL, internalizing SARS-CoV-2. The present study aims to evaluate if the circulating ACE2 activity and the serum levels of AXL and its ligand Gas6 are related with the disease prognosis.

Methods

During the first wave of COVID-19 pandemic, first emergency attendance serum samples were collected from 1519 COVID-19 patients diagnosed at two centers. Age, sex, comorbidities and clinical and analytical variables were collected from the patient’s records. Patients that were admitted to intensive care unit, required mechanical ventilation or died due to COVID-19 were considered severe patients. Serum ACE2 activity was measured by fluorescence enzymatic activity assay while Gas6 and sAXL by ELISA.

Results

Patients with severe COVID-19 were older and presented more comorbidities (Table 1). Circulating ACE2 activity and Gas6 levels were increased in 0.43ng/μL and in 5ng/mL respectively (95%IC:0.32–0.54, p<0.001; 95%IC:3.44–6.56, p<0.001) in patients that afterwards developed severe COVID-19 (Table 1). However, we found no differences in levels of sAXL between patients with severe and non-severe COVID-19. A logistic regression model adjusted by age, sex, diabetes, hypertension, obesity, cardiovascular disease and chronic kidney disease identified that high circulating ACE2 activity and high Gas6 levels were independently associated with worse SARS-CoV2 disease (OR:2.5, 95%CI:2.02–3.25, p<0.001; OR:1.0, 95%CI:1.01–1.04, p<0,001, respectively).

Conclusion

Elevated circulating ACE2 activity and GAS6 at admission to the Emergency Department are a risk factor for severe COVID-19 disease. In contrast, sAXL levels are not related to the severity of the disease.

Funding

• Private Foundation Support