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J Pediatr Infect Dis 2024; 19(02): 089-100
DOI: 10.1055/s-0043-1777840
Original Article

The Relationship between Soluble Angiotensin-Converting Enzyme Level and Coronavirus Disease 2019 in Children: A Prospective Cohort Study

Hacer Efnan Melek Arsoy 
1   Department of Pediatrics, Faculty of Medicine, Sakarya University, Sakarya, Turkey
,
Bahri Elmas 
1   Department of Pediatrics, Faculty of Medicine, Sakarya University, Sakarya, Turkey
,
Ayşe Tarim 
1   Department of Pediatrics, Faculty of Medicine, Sakarya University, Sakarya, Turkey
,
Pınar Dervişoğlu Çavdar 
2   Division of Pediatric Cardiology, Department of Pediatrics, Faculty of Medicine, Sakarya University, Sakarya, Turkey
,
Mehmet Fatih Orhan 
3   Division of Pediatric Hematology and Oncology, Department of Pediatrics, Faculty of Medicine, Sakarya University, Sakarya, Turkey
,
Hayrullah Yazar 
4   Department of Medical Biochemistry, Faculty of Medicine, Sakarya University, Sakarya, Turkey
› Author Affiliations Funding None.
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Abstract

Objective Our objective was to investigate soluble angiotensin-converting enzyme (sACE) levels in pediatric patients with coronavirus disease 2019 (COVID-19) and to identify factors associated with the occurrence and severity of pediatric COVID-19.

Methods This was a prospective cohort study conducted between April 2020 and July 2020. The study population consisted of 143 children (between 1 month and 18 years old), 103 of whom had COVID-19 and 40 of whom were negative for COVID-19 (randomly selected). The sACE levels and other laboratory data of all participants were measured at admission (day 0, baseline). Repeat measurements were performed in patients on the 5th day. Disease severity was documented at baseline and on the 5th day, and the change in severity between these time points was recorded.

Results Age and sex distribution were similar in the two groups. At baseline, 31 (30.1%) of the patients were asymptomatic, 58 (56.3%) had mild disease, and 14 (13.6%) had moderate disease. Baseline sACE levels were similar in the groups (p = 0.120). Higher weight was independently associated with low sACE levels in children (p = 0.037). The sACE level of patients on the 5th day was significantly lower compared with baseline (p = 0.007). Patients who experienced a decrease in disease severity were compared with those who did not demonstrate a decrease. Baseline sACE levels were significantly lower in those who experienced decreased severity (p = 0.039). Multiple linear regression revealed that COVID-19 severity at baseline was independently associated with the low sACE level at baseline (p = 0.023).

Conclusion Lower sACE at diagnosis was associated with COVID-19 severity in children. However, no strong evidence was found that could suggest the sACE level as an important predictor for the occurrence or severity of COVID-19 in children.

Keywords

children - prospective study - COVID-19 - ACE - angiotensin


Publication History

Received: 19 April 2023

Accepted: 28 November 2023

Article published online:
04 March 2024

© 2024. Thieme. All rights reserved.

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany

 

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