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  1. Article ; Online: Coronavirus disease 2019 (COVID-19) and the renin-angiotensin system: A closer look at angiotensin-converting enzyme 2 (ACE2).

    Zemlin, Annalise E / Wiese, Owen J

    Annals of clinical biochemistry

    2020  Volume 57, Issue 5, Page(s) 339–350

    Abstract: Since the first cases of atypical pneumonia linked to the Huanan Seafood Wholesale Market in Wuhan, China, were described in late December 2019, the global landscape has changed radically. In March 2020, the World Health Organization declared COVID-19 a ... ...

    Abstract Since the first cases of atypical pneumonia linked to the Huanan Seafood Wholesale Market in Wuhan, China, were described in late December 2019, the global landscape has changed radically. In March 2020, the World Health Organization declared COVID-19 a global pandemic, and at the time of writing this review, just over three million individuals have been infected with more than 200,000 deaths globally. Numerous countries are in 'lockdown', social distancing is the new norm, even the most advanced healthcare systems are under pressure, and a global economic recession seems inevitable. A novel coronavirus (SARS-CoV-2) was identified as the aetiological agent. From experience with previous coronavirus epidemics, namely the severe acute respiratory syndrome (SARS) and Middle East Respiratory Syndrome (MERS) in 2004 and 2012 respectively, it was postulated that the angiotensin-converting enzyme-2 (ACE2) receptor is a possible port of cell entry. ACE2 is part of the renin-angiotensin system and is also associated with lung and cardiovascular disorders and inflammation. Recent studies have confirmed that ACE2 is the port of entry for SARS-CoV-2. Male sex, advanced age and a number of associated comorbidities have been identified as risk factors for infection with COVID-19. Many high-risk COVID-19 patients with comorbidities are on ACE inhibitors and angiotensin receptor blockers, and this has sparked debate about whether to continue these treatment regimes. Attention has also shifted to ACE2 being a target for future therapies or vaccines against COVID-19. In this review, we discuss COVID-19 and its complex relationship with ACE2.
    MeSH term(s) Angiotensin-Converting Enzyme 2 ; Angiotensin-Converting Enzyme Inhibitors/pharmacology ; Angiotensin-Converting Enzyme Inhibitors/therapeutic use ; Animals ; Betacoronavirus/drug effects ; Betacoronavirus/immunology ; Betacoronavirus/metabolism ; COVID-19 ; Coronavirus Infections/drug therapy ; Coronavirus Infections/immunology ; Coronavirus Infections/metabolism ; Humans ; Pandemics ; Peptidyl-Dipeptidase A/immunology ; Peptidyl-Dipeptidase A/metabolism ; Pneumonia, Viral/drug therapy ; Pneumonia, Viral/immunology ; Pneumonia, Viral/metabolism ; Renin-Angiotensin System/drug effects ; Renin-Angiotensin System/physiology ; SARS-CoV-2
    Chemical Substances Angiotensin-Converting Enzyme Inhibitors ; Peptidyl-Dipeptidase A (EC 3.4.15.1) ; ACE2 protein, human (EC 3.4.17.23) ; Angiotensin-Converting Enzyme 2 (EC 3.4.17.23)
    Keywords covid19
    Language English
    Publishing date 2020-06-02
    Publishing country England
    Document type Journal Article ; Review
    ZDB-ID 390309-6
    ISSN 1758-1001 ; 0004-5632
    ISSN (online) 1758-1001
    ISSN 0004-5632
    DOI 10.1177/0004563220928361
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article: Coronavirus disease 2019 (COVID-19) and the renin-angiotensin system: A closer look at angiotensin-converting enzyme 2 (ACE2)

    Zemlin, Annalise E / Wiese, Owen J

    Ann Clin Biochem

    Abstract: Since the first cases of atypical pneumonia linked to the Huanan Seafood Wholesale Market in Wuhan, China, were described in late December 2019, the global landscape has changed radically. In March 2020, the World Health Organization declared COVID-19 a ... ...

    Abstract Since the first cases of atypical pneumonia linked to the Huanan Seafood Wholesale Market in Wuhan, China, were described in late December 2019, the global landscape has changed radically. In March 2020, the World Health Organization declared COVID-19 a global pandemic, and at the time of writing this review, just over three million individuals have been infected with more than 200,000 deaths globally. Numerous countries are in 'lockdown', social distancing is the new norm, even the most advanced healthcare systems are under pressure, and a global economic recession seems inevitable. A novel coronavirus (SARS-CoV-2) was identified as the aetiological agent. From experience with previous coronavirus epidemics, namely the severe acute respiratory syndrome (SARS) and Middle East Respiratory Syndrome (MERS) in 2004 and 2012 respectively, it was postulated that the angiotensin-converting enzyme-2 (ACE2) receptor is a possible port of cell entry. ACE2 is part of the renin-angiotensin system and is also associated with lung and cardiovascular disorders and inflammation. Recent studies have confirmed that ACE2 is the port of entry for SARS-CoV-2. Male sex, advanced age and a number of associated comorbidities have been identified as risk factors for infection with COVID-19. Many high-risk COVID-19 patients with comorbidities are on ACE inhibitors and angiotensin receptor blockers, and this has sparked debate about whether to continue these treatment regimes. Attention has also shifted to ACE2 being a target for future therapies or vaccines against COVID-19. In this review, we discuss COVID-19 and its complex relationship with ACE2.
    Keywords covid19
    Publisher WHO
    Document type Article
    Note WHO #Covidence: #176123
    Database COVID19

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  3. Article ; Online: Coronavirus disease 2019 (COVID-19) and the renin-angiotensin system

    Zemlin, Annalise E / Wiese, Owen J

    Annals of Clinical Biochemistry: International Journal of Laboratory Medicine

    A closer look at angiotensin-converting enzyme 2 (ACE2)

    2020  Volume 57, Issue 5, Page(s) 339–350

    Abstract: Since the first cases of atypical pneumonia linked to the Huanan Seafood Wholesale Market in Wuhan, China, were described in late December 2019, the global landscape has changed radically. In March 2020, the World Health Organization declared COVID-19 a ... ...

    Abstract Since the first cases of atypical pneumonia linked to the Huanan Seafood Wholesale Market in Wuhan, China, were described in late December 2019, the global landscape has changed radically. In March 2020, the World Health Organization declared COVID-19 a global pandemic, and at the time of writing this review, just over three million individuals have been infected with more than 200,000 deaths globally. Numerous countries are in ‘lockdown’, social distancing is the new norm, even the most advanced healthcare systems are under pressure, and a global economic recession seems inevitable. A novel coronavirus (SARS-CoV-2) was identified as the aetiological agent. From experience with previous coronavirus epidemics, namely the severe acute respiratory syndrome (SARS) and Middle East Respiratory Syndrome (MERS) in 2004 and 2012 respectively, it was postulated that the angiotensin-converting enzyme-2 (ACE2) receptor is a possible port of cell entry. ACE2 is part of the renin-angiotensin system and is also associated with lung and cardiovascular disorders and inflammation. Recent studies have confirmed that ACE2 is the port of entry for SARS-CoV-2. Male sex, advanced age and a number of associated comorbidities have been identified as risk factors for infection with COVID-19. Many high-risk COVID-19 patients with comorbidities are on ACE inhibitors and angiotensin receptor blockers, and this has sparked debate about whether to continue these treatment regimes. Attention has also shifted to ACE2 being a target for future therapies or vaccines against COVID-19. In this review, we discuss COVID-19 and its complex relationship with ACE2.
    Keywords Clinical Biochemistry ; General Medicine ; covid19
    Language English
    Publisher SAGE Publications
    Publishing country us
    Document type Article ; Online
    ZDB-ID 390309-6
    ISSN 1758-1001 ; 0004-5632
    ISSN (online) 1758-1001
    ISSN 0004-5632
    DOI 10.1177/0004563220928361
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  4. Article ; Online: The association between acid-base status and clinical outcome in critically ill COVID-19 patients admitted to intensive care unit with an emphasis on high anion gap metabolic acidosis.

    Zemlin, Annalise E / Sigwadhi, Lovemore N / Wiese, Owen J / Jalavu, Thumeka P / Chapanduka, Zivanai C / Allwood, Brian W / Tamuzi, Jacques L / Koegelenberg, Coenraad F / Irusen, Elvis M / Lalla, Usha / Ngah, Veranyuy D / Yalew, Anteneh / Erasmus, Rajiv T / Matsha, Tandi E / Zumla, Alimuddin / Nyasulu, Peter S

    Annals of clinical biochemistry

    2022  Volume 60, Issue 2, Page(s) 86–91

    Abstract: Objective: The aim of this study was to identify arterial blood gas (ABG) abnormalities, with a focus on a high anion gap (AG) metabolic acidosis and evaluate outcomes in coronavirus disease 2019 (COVID-19) patients admitted to the ICU.: Methods: A ... ...

    Abstract Objective: The aim of this study was to identify arterial blood gas (ABG) abnormalities, with a focus on a high anion gap (AG) metabolic acidosis and evaluate outcomes in coronavirus disease 2019 (COVID-19) patients admitted to the ICU.
    Methods: A retrospective, observational study was conducted in a tertiary hospital in Cape Town during the first and second COVID-19 waves. Age, gender, sodium (Na), potassium (K), chloride (Cl), bicarbonate (HCO
    Results: This study included 465 patients, 226 (48%) of whom were female. The sample population's median (IQR) age was 54.2 (46.1-61.3) years, and 63% of the patients died. ABG analyses found that 283 (61%) of the 465 patients had alkalosis (pH ≥ 7.45), 65 (14%) had acidosis (pH ≤ 7.35) and 117 (25%) had normal pH (7.35-7.45). In the group with alkalosis, 199 (70.3%) had a metabolic alkalosis and in the group with acidosis, 42 (64%) had a metabolic acidosis with an increased AG of more than 17. Non-survivors were older than survivors (56.4 years versus 50.3 years,
    Conclusion: Most of the COVID-19 patients admitted to the ICU had an alkalosis, and those with acidosis had a much worse prognosis. Higher AG metabolic acidosis was not associated with patients' characteristics.
    MeSH term(s) Humans ; Female ; Middle Aged ; Male ; Acid-Base Equilibrium ; Retrospective Studies ; Critical Illness ; COVID-19 ; South Africa ; Acidosis ; Alkalosis ; Intensive Care Units
    Language English
    Publishing date 2022-11-07
    Publishing country England
    Document type Observational Study ; Journal Article
    ZDB-ID 390309-6
    ISSN 1758-1001 ; 0004-5632
    ISSN (online) 1758-1001
    ISSN 0004-5632
    DOI 10.1177/00045632221134687
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  5. Article ; Online: Correlating arterial blood gas, acid-base and blood pressure abnormalities with outcomes in COVID-19 intensive care patients.

    Bezuidenhout, Morne C / Wiese, Owen J / Moodley, Desiree / Maasdorp, Elizna / Davids, Mogamat R / Koegelenberg, Coenraad Fn / Lalla, Usha / Khine-Wamono, Aye A / Zemlin, Annalise E / Allwood, Brian W

    Annals of clinical biochemistry

    2020  Volume 58, Issue 2, Page(s) 95–101

    Abstract: Background: During the outbreak of coronavirus disease 2019 (COVID-19), many studies have investigated laboratory biomarkers in management and prognostication of COVID-19 patients, however to date, few have investigated arterial blood gas, acid-base and ...

    Abstract Background: During the outbreak of coronavirus disease 2019 (COVID-19), many studies have investigated laboratory biomarkers in management and prognostication of COVID-19 patients, however to date, few have investigated arterial blood gas, acid-base and blood pressure patterns. The aim of the study is to assess the arterial blood gas and acid-base patterns, blood pressure findings and their association with the outcomes of COVID-19 patients admitted to an intensive care unit.
    Methods: A single-centre retrospective, observational study in a dedicated COVID-19 intensive care unit in Cape Town, South Africa. Admission arterial blood gas, serum electrolytes, renal function and blood pressure readings performed on COVID-19 patients admitted between 26 March and 2 June 2020 were analysed and compared between survivors and non-survivors.
    Results: A total of 56 intensive care unit patients had admission arterial blood gas performed at the time of intensive care unit admission. An alkalaemia (pH > 7.45) was observed in 36 (64.3%) patients. A higher arterial pH (median 7.48 [interquartile range: 7.45-7.51] versus 7.46 [interquartile range: 7.40-7.48],
    Conclusions: The majority of the study population admitted to intensive care unit had an alkalaemia on arterial blood gas. A higher pH and lower partial pressure of oxygen in arterial blood on arterial blood gas analysis were significantly associated with survival.
    MeSH term(s) Acid-Base Equilibrium ; Adult ; Biomarkers/blood ; Blood Gas Analysis ; Blood Pressure ; COVID-19/blood ; COVID-19/mortality ; COVID-19/physiopathology ; COVID-19/therapy ; Critical Care ; Female ; Humans ; Intensive Care Units ; Male ; Middle Aged ; Retrospective Studies ; SARS-CoV-2/metabolism
    Chemical Substances Biomarkers
    Keywords covid19
    Language English
    Publishing date 2020-11-20
    Publishing country England
    Document type Journal Article ; Observational Study
    ZDB-ID 390309-6
    ISSN 1758-1001 ; 0004-5632
    ISSN (online) 1758-1001
    ISSN 0004-5632
    DOI 10.1177/0004563220972539
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  6. Article: EXPRESS: Correlating arterial blood gas, acid-base and blood pressure abnormalities with outcomes in COVID-19 intensive care patients

    Bezuidenhout, Morne C / Wiese, Owen J / Moodley, Desiree / Maasdorp, Elizna / Davids, Mogamat Razeen / Koegenlenberg, Coenraad Fn / Lalla, Usha / Khine-Wamono, Aye Aye / Zemlin, Annalise E / Allwood, Brian W

    Ann Clin Biochem

    Abstract: BACKGROUND: During the outbreak of coronavirus disease 2019 (COVID-19) many studies have investigated laboratory biomarkers in management and prognostication of COVID-19 patients, however to date, few have investigated arterial blood gas (ABG), acid-base ...

    Abstract BACKGROUND: During the outbreak of coronavirus disease 2019 (COVID-19) many studies have investigated laboratory biomarkers in management and prognostication of COVID-19 patients, however to date, few have investigated arterial blood gas (ABG), acid-base and blood pressure (BP) patterns. The aim of the study is to assess the ABG and acid-base patterns, BP findings and their association with the outcomes of COVID-19 patients admitted to an intensive care unit (ICU). METHODS: A single-centre retrospective, observational study in a dedicated COVID-19 ICU in Cape Town, South Africa. Admission ABG, serum electrolytes, renal function and BP readings performed on COVID-19 patients admitted between 26 March and 2 June 2020 were analysed and compared between survivors and non-survivors. RESULTS: A total of 56 ICU patients had admission ABG performed at the time of ICU admission. An alkalaemia (pH > 7.45) was observed in 36 (64.3%) patients. A higher arterial pH [median 7.48 (IQR: 7.45-7.51 vs. 7.46 (IQR: 7.40-7.48), p=0.049] and partial pressure of oxygen in arterial blood [PaO2; median 7.9kPa (IQR 7.3- 9.6) vs. 6.5kPa (IQR: 5.2-7.3), p=<0.001] were significantly associated with survival. Survivors also tended to have a higher systolic BP [median: 144mmHg (IQR: 134- 152) vs. 139mmHg (IQR: 125-142), p=0.078] and higher arterial HCO3 [median: 28.0mmol/L (IQR: 25.7- 28.8) vs. 26.3mmol/L (IQR: 24.3-27.9); p=0.059). CONCLUSIONS: The majority of the study population admitted to ICU had an alkalaemia on ABG. A higher pH and lower PaO2 on ABG analysis were significantly associated with survival.
    Keywords covid19
    Publisher WHO
    Document type Article
    Note WHO #Covidence: #890020
    Database COVID19

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  7. Article ; Online: EXPRESS

    Bezuidenhout, Morne C / Wiese, Owen J / Moodley, Desiree / Maasdorp, Elizna / Davids, Mogamat Razeen / Koegenlenberg, Coenraad FN / Lalla, Usha / Khine-Wamono, Aye Aye / Zemlin, Annalise E. / Allwood, Brian W

    Annals of Clinical Biochemistry: International Journal of Laboratory Medicine

    Correlating arterial blood gas, acid-base and blood pressure abnormalities with outcomes in COVID-19 intensive care patients

    2020  , Page(s) 456322097253

    Abstract: Background: During the outbreak of coronavirus disease 2019 (COVID-19) many studies have investigated laboratory biomarkers in management and prognostication of COVID-19 patients, however to date, few have investigated arterial blood gas (ABG), acid-base ...

    Abstract Background: During the outbreak of coronavirus disease 2019 (COVID-19) many studies have investigated laboratory biomarkers in management and prognostication of COVID-19 patients, however to date, few have investigated arterial blood gas (ABG), acid-base and blood pressure (BP) patterns. The aim of the study is to assess the ABG and acid-base patterns, BP findings and their association with the outcomes of COVID-19 patients admitted to an intensive care unit (ICU). Methods: A single-centre retrospective, observational study in a dedicated COVID-19 ICU in Cape Town, South Africa. Admission ABG, serum electrolytes, renal function and BP readings performed on COVID-19 patients admitted between 26 March and 2 June 2020 were analysed and compared between survivors and non-survivors. Results: A total of 56 ICU patients had admission ABG performed at the time of ICU admission. An alkalaemia (pH > 7.45) was observed in 36 (64.3%) patients. A higher arterial pH [median 7.48 (IQR: 7.45-7.51 vs. 7.46 (IQR: 7.40-7.48), p=0.049] and partial pressure of oxygen in arterial blood [PaO2; median 7.9kPa (IQR 7.3- 9.6) vs. 6.5kPa (IQR: 5.2-7.3), p=<0.001] were significantly associated with survival. Survivors also tended to have a higher systolic BP [median: 144mmHg (IQR: 134- 152) vs. 139mmHg (IQR: 125-142), p=0.078] and higher arterial HCO3 [median: 28.0mmol/L (IQR: 25.7- 28.8) vs. 26.3mmol/L (IQR: 24.3-27.9); p=0.059). Conclusions: The majority of the study population admitted to ICU had an alkalaemia on ABG. A higher pH and lower PaO2 on ABG analysis were significantly associated with survival.
    Keywords Clinical Biochemistry ; General Medicine ; covid19
    Language English
    Publisher SAGE Publications
    Publishing country us
    Document type Article ; Online
    ZDB-ID 390309-6
    ISSN 1758-1001 ; 0004-5632
    ISSN (online) 1758-1001
    ISSN 0004-5632
    DOI 10.1177/0004563220972539
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

    More links

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