RESUMO
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) employs angiotensin-converting enzyme 2 (ACE2) as its receptor for cell entrance, and studies have suggested that upon viral binding, ACE2 catalytic activity could be inhibited; therefore, impacting the regulation of the renin-angiotensin-aldosterone system (RAAS). To date, only few studies have evaluated the impact of SARS-CoV-2 infection on the blood levels of the components of the RAAS. The objective of this study was to determine the blood levels of ACE, ACE2, angiotensin-II, angiotensin (1-7), and angiotensin (1-9) at hospital admission and discharge in a group of patients presenting with severe or critical evolution of coronavirus disease 2019 (COVID-19). We showed that ACE, ACE2, angiotensin (1-7), and angiotensin (1-9) were similar in patients with critical and severe COVID-19. However, at admission, angiotensin-II levels were significantly higher in patients presenting as critical, compared to patients presenting with severe COVID-19. We conclude that blood levels of angiotensin-II are increased in hospitalized patients with COVID-19 presenting the critical outcome of the disease. We propose that early measurement of Ang-II could be a useful biomarker for identifying patients at higher risk for extremely severe progression of the disease.
RESUMO
Este relato tem como objetivo descrever o caso de uma adolescente com 12 anos de idade, que procurou atendimento no pronto-socorro de pediatria do Hospital Universitário de Brasília com queixa de artralgia difusa nos membros inferiores e prejuízo da marcha havia um ano. Com o exame físico e os exames complementares, com positividade de anticorpos anti-U 1-RNP, FAN, anti-La, foi caracterizada a doença mista do tecido conjuntivo e confirmada hipertensão pulmonar.
This report has the aim to describe the case of a 12 years old adolescent, female, admitted at the pediatric emergency unit of the University Hospital of Brasilia with the complaint of arthralgia in inferior members and gait disability. With the examination and laboratorial investigation, with positives antibodies anti-U1-RNP, FAN, anti-La, it was possible to stablish the diagnosis of mixed connective tissue disease and confirm lung hypertension.