Background: Ang II inhibits fibrinolysis and promotes the production of thrombin. The elevation in Ang II levels is substantially linked to lung injury and viral load in cases with severe Corona Virus Infectious Disease 2019 (COVID-19).
Aim of the work: This study aimed to determine the level of serum Ang II as a diagnostic biomarker of COVID-19 severity and a prognostic biomarker for the outcome in confirmed COVID-19 children.
Patients and Methods: This case-control study was carried out on 45 positive COVID-19 Real-time polymerase chain reaction (RT-PCR) children as the cases and 45 healthy children as the controls. Clinical examination, laboratory assays, and imaging studies were done on the patients to determine COVID–19 infection severity. Serum Ang-II was evaluated utilizing Enzyme-Linked Immunosorbent Assay (ELISA) for both groups as well as linked to patients' radiological, laboratory, and clinical parameters.
Results: The levels of serum Ang II were substantially elevated in the cases compared to controls (p-value= 0.001) and in the non-survivor COVID-19 group than in the survivor group (p-value = 0.0001). The median serum Ang II level in COVID-19 cases was 100 interquartile range (IQR):88-137) ng/L and 20 (IQR:15-25) ng/L in the controls respectively. There were statistically significant positive correlations between serum Ang II as well as clinical parameters and different grades of clinical severity classifications, laboratory parameters and radiological parameters according to COVID-19 Reporting and Data System (Co-RAD) score of Computed tomography (CT) chest of the patient group.
Conclusion: We concluded that early measurement of Ang II serum levels in confirmed COVID-19 children might be a helpful diagnostic and prognostic biomarker to identify high-risk patients for highly severe disease progression.