ACE2, COVID19 and serum ACE as a possible biomarker to predict severity of disease

Kolberg, Espen Skarstein

doi:10.1016/j.jcv.2020.104350

Cited by 31 publications

(21 citation statements)

References 5 publications

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“…It was also well-known that children express higher ACE levels and lower levels of ACE2 in their sera, with the consideration of the antagonistic relationship between ACE and ACE2. The levels of these molecules are almost different in adults (78,79). We believe that this issue concerning the low expression, maturation, and distribution of the receptors to the virus represents the principal factor for warranting the low infection rates and mild disease expression in children over adults.…”

Section: The Explanation For Low Infectivity Rates and Benign Pediatrmentioning

confidence: 99%

Salient Conclusive Remarks on Epidemiology and Clinical Manifestations of Pediatric COVID-19: Narrative Review

et al. 2020

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The ongoing pandemic of COVID-19, which is caused by the novel coronavirus named severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), constituted significant public health concerns and impacted the human populations with massive economic and social burdens worldwide. The disease is known to infect people of all ages, including children, adults, and the elderly. Although several reports about pediatric COVID-19 were seen in the literature, we believe that the epidemiology and pathology of the infection described in these reports are not conclusive. Therefore, in this scientific communication, a narrative review study was performed to shed some light on the characteristic epidemiological features and clinical phenotypes of pediatric COVID-19. In this report, we had compiled and presented the different epidemiological features of the disease related to the age of infection, virus acquisition, explanations of the low infectivity rates, and consequences of infections. The discriminatory clinical manifestations of the disease in children were also addressed and discussed in this review. The search included the data published from the date of the start of the pandemic in December 2019 up to October 2020. Our literature search revealed that children of all ages, including neonates, had been infected by the virus. Despite the fact that pediatric COVID-19 is less common to occur, as compared to the disease in adults, the infected children usually manifest the disease symptomatology in benign form. Asymptomatic and symptomatic adult patients are the primary source of the virus to the children. Intrauterine transmission of the virus and breastfeeding infections to the neonates were hypothesized in some studies but ruled out since they were not confirmed. Intensive review and discussion warranting the low infection rates and benign conditions of COVID-19 in children were also made in this study. As documented in many studies, the infectivity, morbidity, and mortality rates of the disease among the children populations are much lower than those in adults. They also seem to be lower than those observed during SARS-CoV and MERS-CoV epidemics. The described clinical phenotypes of COVID-19 in children do not differ much from those of adults, and complications of the disease seem to be associated with comorbidities.

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Section: The Explanation For Low Infectivity Rates and Benign Pediatrmentioning

confidence: 99%

Salient Conclusive Remarks on Epidemiology and Clinical Manifestations of Pediatric COVID-19: Narrative Review

et al. 2020

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“…15 Several studies have indicated that the significant difference in the frequency of COVID-19 in children in comparison to adults has a positive correlation with their exposure rate to the population in public areas. 6,16,17 There are some reports suggesting that the lower incidence of severe symptoms among children than in adults is attributed not only to their lower exposure to public risk factors but also can be related to immaturity of angiotensin converting enzyme 2 (ACE2) receptors, which are the sites for COVID-19 binding. The most common cited reason for the age-related difference in the incidence of COVID-19 is the difference in the distribution, maturation and functioning of viral receptors in children as compared to adults.…”

Section: Reasons For Low Covid-19 Incidence Among Childrenmentioning

confidence: 99%

“…20 On the other hand, after the virus enters the host cells, it down regulates ACE2, which results in lower cell susceptibility. 17 Accordingly, ACE2 plays a dual role in cell infection by virus.…”

Section: Reasons For Low Covid-19 Incidence Among Childrenmentioning

confidence: 99%

<p>Coronavirus Disease 2019 (COVID-19) in Children: Prevalence, Diagnosis, Clinical Symptoms, and Treatment</p>

Zare‐Zardini¹,

Soltaninejad²,

Ferdosian³

et al. 2020

IJGM

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In this article, we have reviewed the prevalence, diagnosis, symptoms, and treatment of COVID-19 in children. The incidence of COVID-19 among children under 18 years was 2.1% based on the reported studies, where the mortality rate in the same age group was 0.2%. No death has been reported in children under 9-years old. There are some articles that report children with COVID-19 having symptoms similar to Kawasaki's disease. In these cases, heart complications were observed. The best markers for diagnosing the severity of the disease in children are the levels of bilirubin and hepatic enzymes. Large number of angiotensin converting enzyme 2 (ACE2) receptors on cell surfaces, effective innate immune system, and high level of blood lymphocyte have been reported to be the potent reasons for lower incidence of severe symptoms of COVID-19 among children. Children can very well be the carriers of this virus. Children with severe COVID-19 clinical symptoms, especially those suffering from pneumonia, must be hospitalized similar to adults, while quarantine is required for those having mild symptoms. Antiviral medication (lopinavir, darunavir, favipiravir, remdesivir, ribavirin, oseltamivir, tocilizumab, and umifenovir), ACE inhibitors, interferon-α2b, co-therapy with azithromycin, inhaling iNO, and oxygen therapy can be used for treatment. For the treatment of children without any clinical and infection symptoms, home isolation protocol has been recommended.

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“…In fact, some evidence suggests that ACE2 expression in children is neither up- nor downregulated ( 35 , 36 ). On the other hand, another study found that ACE2 is downregulated once the virus penetrates the cell and replicates, resulting in fewer receptors upon which the virus can act ( 37 ). In light of these data, the role of the expression levels of ACE2 in the pathogenesis of COVID-19-induced lung damage remains to be fully elucidated.…”

Section: Pathogenesis Of Lung Damagementioning

confidence: 99%

COVID-19 Pneumonia in Children: From Etiology to Management

et al. 2020

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COVID-19 is less serious in children than in adults. However, respiratory management dominates the clinical picture of hospitalized COVID-19 even in children. In some case series, deterioration of the clinical picture wherein dyspnea, cyanosis, and the onset of acute respiratory distress syndrome (ARDS) emerged ~8–10 days after the onset of SARS-CoV-2 infection, which could rapidly progress to multiple organ failure and death. This review aimed to evaluate the characteristics of COVID-19 pneumonia in pediatric populations, beginning from its etiology and pathological mechanisms and closing with its clinical management.

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ACE2, COVID19 and serum ACE as a possible biomarker to predict severity of disease

Cited by 31 publications

References 5 publications

Salient Conclusive Remarks on Epidemiology and Clinical Manifestations of Pediatric COVID-19: Narrative Review

Salient Conclusive Remarks on Epidemiology and Clinical Manifestations of Pediatric COVID-19: Narrative Review

<p>Coronavirus Disease 2019 (COVID-19) in Children: Prevalence, Diagnosis, Clinical Symptoms, and Treatment</p>

COVID-19 Pneumonia in Children: From Etiology to Management

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