The Plasmatic Aldosterone and C-Reactive Protein Levels, and the Severity of Covid-19: The Dyhor-19 Study

Orianne Villard (1, 2) , David Morquin (1) , Nicolas Molinari (3) , Isabelle Raingeard (1, 4) , Nicolas Nagot (5) , Jean-Paul Cristol (1, 6) , Boris Jung (6, 1) , Camille Roubille (7, 6) , Vincent Foulongne (1, 5) , Pierre Fesler (1, 6) , Sylvain Lamure (1) , Patrice Taourel (1) , Amadou Konate (1) , Alexandre Thibault Jacques Maria (1, 8) , Alain Makinson (1, 9) , Ivan Bertchansky (1) , R. Larcher (10, 6) , Kada Klouche (1, 6) , Vincent Le Moing (1, 9) , Eric Renard (1, 2) , Philippe Guilpain (8)

1 CHRU Montpellier - Centre Hospitalier Régional Universitaire [Montpellier]
2 IGF - Institut de Génomique Fonctionnelle
3 IMAG - Institut Montpelliérain Alexander Grothendieck
4 CIC Montpellier
5 Pathogénèse et contrôle des infections chroniques (PCCI)
6 PhyMedExp - Physiologie & médecine expérimentale du Cœur et des Muscles [U 1046]
7 Département de Rhumatologie[Montpellier]
8 Cellules Souches, Plasticité Cellulaire, Médecine Régénératrice et Immunothérapies (IRMB)
9 TransVIHMI - Recherches Translationnelles sur le VIH et les maladies infectieuses endémiques et émergentes
10 CHU Nîmes - Centre Hospitalier Universitaire de Nîmes

Background: The new coronavirus SARS-CoV-2, responsible for the Covid-19 pandemic, uses the angiotensin converting enzyme type 2 (ACE2), a physiological inhibitor of the renin angiotensin aldosterone system (RAAS), as a cellular receptor to infect cells. Since the RAAS can induce and modulate pro-inflammatory responses, it could play a key role in the pathophysiology of Covid-19. Thus, we aimed to determine the levels of plasma renin and aldosterone as indicators of RAAS activation in a series of consecutively admitted patients for Covid-19 in our clinic.Methods: Plasma renin and aldosterone levels were measured, among the miscellaneous investigations needed for Covid-19 management, early after admission in our clinic. Disease severity was assessed using a seven-category ordinal scale. Primary outcome of interest was the severity of patients' clinical courses.Results: Forty-four patients were included. At inclusion, 12 patients had mild clinical status, 25 moderate clinical status and 7 severe clinical status. In univariate analyses, aldosterone and C-reactive protein (CRP) levels at inclusion were significantly higher in patients with severe clinical course as compared to those with mild or moderate course (p < 0.01 and p = 0.03, respectively). In multivariate analyses, only aldosterone and CRP levels remained positively associated with severity. We also observed a positive significant correlation between aldosterone and CRP levels among patients with an aldosterone level greater than 102.5 pmol/L.Conclusions: Both plasmatic aldosterone and CRP levels at inclusion are associated with the clinical course of Covid-19. Our findings may open new perspectives in the understanding of the possible role of RAAS for Covid-19 outcome.

Mots clés: Covid-19; endocrine; inflammation; renin angiotensin aldosterone system; severity

Domaines: Sciences du Vivant [q-bio]

Orianne Villard, David Morquin, Nicolas Molinari, Isabelle Raingeard, Nicolas Nagot, et al.. The Plasmatic Aldosterone and C-Reactive Protein Levels, and the Severity of Covid-19: The Dyhor-19 Study. Journal of Clinical Medicine, 2020, 9 (7), pp.2315. ⟨10.3390/jcm9072315⟩. ⟨hal-02906692⟩