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J Clin Med . The Plasmatic Aldosterone and C-Reactive Protein Levels, and the Severity of Covid-19: The Dyhor-19 Study

tetano

Editor, Senior Moderator
J Clin Med


. 2020 Jul 21;9(7):E2315.
doi: 10.3390/jcm9072315.
The Plasmatic Aldosterone and C-Reactive Protein Levels, and the Severity of Covid-19: The Dyhor-19 Study


Orianne Villard[SUP] 1 2 3 [/SUP], David Morquin[SUP] 4 [/SUP], Nicolas Molinari[SUP] 1 5 [/SUP], Isabelle Raingeard[SUP] 2 [/SUP], Nicolas Nagot[SUP] 1 5 [/SUP], Jean-Paul Cristol[SUP] 1 6 [/SUP], Boris Jung[SUP] 1 7 8 [/SUP], Camille Roubille[SUP] 1 8 [/SUP], Vincent Foulongne[SUP] 9 [/SUP], Pierre Fesler[SUP] 1 8 [/SUP], Sylvain Lamure[SUP] 1 4 [/SUP], Patrice Taourel[SUP] 1 10 [/SUP], Amadou Konate[SUP] 11 12 [/SUP], Alexandre Thibault Jacques Maria[SUP] 1 11 13 [/SUP], Alain Makinson[SUP] 1 4 [/SUP], Ivan Bertchansky[SUP] 11 12 [/SUP], Romaric Larcher[SUP] 1 7 8 [/SUP], Kada Klouche[SUP] 1 7 8 [/SUP], Vincent Le Moing[SUP] 1 4 [/SUP], Eric Renard[SUP] 1 2 3 [/SUP], Philippe Guilpain[SUP] 1 11 13 [/SUP]



Affiliations

Abstract

Background: The new coronavirus SARS-CoV-2, responsible for the Covid-19 pandemic, uses the angiotensin converting enzyme type 2 (ACE2), a physiological inhibitor of the renin angiotensin aldosterone system (RAAS), as a cellular receptor to infect cells. Since the RAAS can induce and modulate pro-inflammatory responses, it could play a key role in the pathophysiology of Covid-19. Thus, we aimed to determine the levels of plasma renin and aldosterone as indicators of RAAS activation in a series of consecutively admitted patients for Covid-19 in our clinic.
Methods: Plasma renin and aldosterone levels were measured, among the miscellaneous investigations needed for Covid-19 management, early after admission in our clinic. Disease severity was assessed using a seven-category ordinal scale. Primary outcome of interest was the severity of patients' clinical courses.
Results: Forty-four patients were included. At inclusion, 12 patients had mild clinical status, 25 moderate clinical status and 7 severe clinical status. In univariate analyses, aldosterone and C-reactive protein (CRP) levels at inclusion were significantly higher in patients with severe clinical course as compared to those with mild or moderate course (p < 0.01 and p = 0.03, respectively). In multivariate analyses, only aldosterone and CRP levels remained positively associated with severity. We also observed a positive significant correlation between aldosterone and CRP levels among patients with an aldosterone level greater than 102.5 pmol/L.
Conclusions: Both plasmatic aldosterone and CRP levels at inclusion are associated with the clinical course of Covid-19. Our findings may open new perspectives in the understanding of the possible role of RAAS for Covid-19 outcome.

Keywords: Covid-19; endocrine; inflammation; renin angiotensin aldosterone system; severity.
 
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