Correlations between kidney and heart function bioindicators and the expressions of Toll-Like, ACE2, and NRP-1 receptors in COVID-19

  1. Rabab Hussain Sultan
  2. Maged Abdallah
  3. Tarek Mohamed Ali
  4. Hebatallah Hany Assal
  5. Amr E. Ahmed
  6. Basem H Elesawy
  7. Osama M. Ahmed

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Abstract

Background

COVID-19 impacts the cardiovascular system resulting in myocardial damage and also affects the kidneys leading to renal dysfunction. This effect is mostly through the binding with angiotensin-converting enzyme-2 (ACE2) and Neuropilin-1(NRP-l) receptors. Toll-Like Receptors (TLRs) typically combine with microbial pathogens and provoke an inflammatory response.

Aim

This work aims to compare the changes in kidney and heart function bioindicators and expressions of TLRs (TLR2 and TLR2) as well as ACE2 and NRP-l receptors in moderate and severe COVID-19 patients. The correlations between kidney and heart function bioindicators and expressions of these receptors are also studied.

Patients and Methods

In this study, 50 healthy control and 100 COVID-19 patients (55 male and 45 female) were enrolled. According to WHO guidelines, these participants were divided into severe (50 cases) and moderate (50 cases). Serum creatinine, blood urea, CKMB, LDH, and Troponin I were estimated. We measured the gene expression for Toll-Like Receptors (TLR2, TLR4), ACE2, and NRP-1 in the blood samples using quantitative real-time PCR (qRT -PCR).

Results

In comparison with the healthy group, all patients exhibited a significant elevation in the serum creatinine, blood urea, cardiac enzymes, and CRP. As well, all studied patients revealed a significant elevation in the expression levels of TLR2, TLR4, ACE2, and NRP-1 mRNA. In all patients, CKMB, ACE2, and NRP-1 mRNA expression levels were positively correlated to both TLR2 and TLR4 expression levels. Moreover, serum creatinine and blood urea were positively correlated to both TLR2 and TLR 4 expression levels in the severe group only.

Conclusions

Our study concluded that expression levels for TLR2, TLR4, ACE2, and NRP-1 mRNA in both severe and moderate patients were positively correlated with renal biomarkers and cardiac enzymes. Innate immune markers can be important because they correlate with the severity of illness in COVID-19.

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  1. ScreenIT

    SciScore for 10.1101/2022.04.08.22273322: (What is this?)

    Please note, not all rigor criteria are appropriate for all manuscripts.

    Table 1: Rigor

    EthicsConsent: Informed printed consent was taken from all participants after the ethical committee of the institutional review board was permitted this research.
    IRB: Informed printed consent was taken from all participants after the ethical committee of the institutional review board was permitted this research.
    Sex as a biological variableKey exclusion criteria included hypertensive patients treated with ACE2 inhibitors, pre-existing respiratory disorder, kidney or liver failure, thyroid dysfunction, autoimmune disorders, cerebrovascular diseases, heart diseases, pregnant and lactating women.
    Randomizationnot detected.
    Blindingnot detected.
    Power Analysisnot detected.

    Table 2: Resources

    No key resources detected.

    Results from OddPub: We did not detect open data. We also did not detect open code. Researchers are encouraged to share open data when possible (see Nature blog).

    Results from LimitationRecognizer: An explicit section about the limitations of the techniques employed in this study was not found. We encourage authors to address study limitations.

    Results from TrialIdentifier: No clinical trial numbers were referenced.

    Results from Barzooka: We did not find any issues relating to the usage of bar graphs.

    Results from JetFighter: We did not find any issues relating to colormaps.

    Results from rtransparent:
    • Thank you for including a conflict of interest statement. Authors are encouraged to include this statement when submitting to a journal.
    • Thank you for including a funding statement. Authors are encouraged to include this statement when submitting to a journal.
    • No protocol registration statement was detected.

    Results from scite Reference Check: We found no unreliable references.

    About SciScore

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  2. Version published to 10.1101/2022.04.08.22273322v1 on medRxiv