{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,4]],"date-time":"2025-11-04T18:02:36Z","timestamp":1762279356152,"version":"build-2065373602"},"reference-count":0,"publisher":"Journal of Infection in Developing Countries","issue":"10","license":[{"start":{"date-parts":[[2025,10,31]],"date-time":"2025-10-31T00:00:00Z","timestamp":1761868800000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Infect Dev Ctries"],"abstract":"<jats:p>Introduction: The potential role of the renin-angiotensin-aldosterone system (RAAS) in the pathogenesis of coronavirus disease 2019 (COVID-19) is controversial, with concerns mainly about the part RAAS peptides play in the prediction of progression to more severe disease. Given the importance of COVID-19 prognostication at early disease stages, we established and validated a multivariable risk stratification tool for COVID-19 associated lung involvement by utilizing a combination of RAAS peptides.\nMethodology: In this prospective study, circulating renin and angiotensin converting enzyme-2 (ACE-2) levels were measured in 116 COVID-19 patients who were admitted to our hospital from March 30, 2021 to January 24, 2022 and underwent a lung computed tomography (CT) scan. Clinical severity was measured with a national early warning score (NEWS). Associations among RAAS peptides, inflammation-dependent biomarkers, demographic variables, and clinical outcomes were studied using logistic regression and Cox proportional-hazards models.\nResults: We assessed 116 COVID-19 patients (mean age 45.1 \u00b1 12.6 years; 51.7% male), of whom 66 (56.9%) had COVID-19 associated pneumonia. Baseline circulating ACE-2 (2.63 \u00b1 0.12 ng\/mL) and renin levels (85.04 \u00b1 6.8 ng\/L) were lower in patients with COVID-19 related pneumonia compared to patients without pneumonia (6.4 \u00b1 0.7 ng\/mL and 211.6 \u00b1 21.9 ng\/L, respectively) (p &lt; 0.001 for both). Both RAAS components were found to be significantly related to adverse outcomes, including COVID-19 associated pneumonia and intensive care unit (ICU) admission, in both crude and adjusted multivariable logistic regression analyses.\nConclusions: Circulating ACE-2 and renin levels can predict lung involvement in COVID-19 patients, and they display good correlation and agreement with NEWS.<\/jats:p>","DOI":"10.3855\/jidc.21313","type":"journal-article","created":{"date-parts":[[2025,11,4]],"date-time":"2025-11-04T17:57:48Z","timestamp":1762279068000},"page":"1432-1442","source":"Crossref","is-referenced-by-count":0,"title":["A prediction model for lung involvement using circulating angiotensin converting enzyme-2 and renin levels in COVID-19 patients"],"prefix":"10.3855","volume":"19","author":[{"ORCID":"https:\/\/orcid.org\/0009-0000-0930-0278","authenticated-orcid":false,"given":"Cansu","family":"Akkan","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0893-6084","authenticated-orcid":false,"given":"Murat","family":"Da\u015f","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Okan","family":"Bardakci","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"M\u00fc\u015ferref Hilal","family":"\u015eehito\u011flu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"G\u00f6khan","family":"Akdur","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3427-5649","authenticated-orcid":false,"given":"Canan","family":"Akman","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Okhan","family":"Akdur","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6247-2714","authenticated-orcid":false,"given":"Yavuz","family":"Beyazit","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"2222","published-online":{"date-parts":[[2025,10,31]]},"container-title":["The Journal of Infection in Developing Countries"],"original-title":[],"link":[{"URL":"https:\/\/www.jidc.org\/index.php\/journal\/article\/download\/21313\/3743","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.jidc.org\/index.php\/journal\/article\/download\/21313\/3743","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,11,4]],"date-time":"2025-11-04T17:57:48Z","timestamp":1762279068000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.jidc.org\/index.php\/journal\/article\/view\/21313"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,10,31]]},"references-count":0,"journal-issue":{"issue":"10","published-online":{"date-parts":[[2025,10,31]]}},"URL":"https:\/\/doi.org\/10.3855\/jidc.21313","relation":{},"ISSN":["1972-2680"],"issn-type":[{"value":"1972-2680","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,10,31]]}}}