A blood test could help predict the course of Covid-19

A group of researchers has detected alterations in the Ace2 protein, the "key to access" of Sars-Cov-2 in human cells, in the blood of infected patients. It could become a method for studying the course of the disease

Photo: Nguyen Hiep | Unsplash Once infected with Sars-Cov-2, predicting how its course will be is not easy: the prognosis of Covid-19 varies from person to person, and it can be difficult to hazard a prediction. What would happen if instead blood tests were enough to monitor the progress of the infection? This is what the researchers of the Umh-Csic Neurosciences Institute in Alicante, Spain hypothesized, studying the amount in the blood of infected patients of the Ace2 protein, the receptor that allows the coronavirus to enter cells. In the acute phases of the infection they found a significant decrease in the protein. This could lead to an innovative, simple and minimally invasive method of monitoring Sars-Cov-2 infection, simply with a blood test. The results of the study were published in the Faseb Journal.

It all started with Alzheimer's

Angiotensin converting enzyme 2 (Ace2) is a protein found primarily in the tissues of the lungs and oral and nasal mucous membranes, but also in non-respiratory sites such as the gastrointestinal tract, kidneys, adrenal glands, heart, testes, liver and brain. In short, in humans this protein is widely expressed, a little in all body sites. It has various physiological functions, including participating in the synthesis of molecules with a vaso-dilator and anti-inflammatory effect, but above all it allows Sars-Cov-2 to bind to the cells and provides it with an access key to enter it.

Although the presence of this blood protein is linked to various pathological conditions and inflammatory states, it had not been investigated in detail in association with coronavirus infection. The idea came to the Alicante team, led by Javier Sáez-Valero, and started from what is most different from Sars-Cov-2: Alzheimer's disease. The main line of research of the group, in fact, is precisely to study the onset and course of this degenerative disease, especially through the quantification of a molecule (called APP), present in the cerebrospinal fluid, which functions as a biomarker. APP is processed by the same class of enzymes that Ace2 processes: why not think of a method to monitor Sars-Cov-2 infection by analyzing the quantities of a biomarker?

The study and the results

The study, carried out during the first wave of the pandemic, identified, through the national biobank Isabial Biobank, 59 people with a positive molecular test for Sars-Cov-2, with an average age of 64 years: these have developed Covid-19 in a moderate or severe manner and within 10 days of the onset of symptoms they were all hospitalized. In addition, patients with influenza virus pneumonia were also analyzed to test the specificity of the marker. The Ace2 protein in human plasma has been identified through a technique that allows the precise detection of the quantity of a specific molecule in a given tissue.

The data have shown that patients with Covid-19, in the acute phase. of the infection, had significantly lower levels of the Ace2 protein in their blood than in non-infected people; in remission from the infection, however, the levels of protein in the blood returned to normal. In addition to the entire Ace2 molecule, a cut shape was also measured, which derives from interaction with the virus. The researchers observed that in this case during the acute phase of the infection the cut form of Ace2 increased, which did not happen in either healthy patients or those with influenza.

The results of the study, therefore. , suggest that plasma Ace2 levels could be a good way to measure the evolution of coronavirus infection. According to the researchers, further investigations are needed on the potential of this molecule as a biomarker, both of the disease and following vaccination against Covid-19. The next step? To study what happens to these proteins in positive but asymptomatic individuals or in people who have received the vaccine.




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