Severe COVID-19 induces autoantibodies against angiotensin II that correlate with blood pressure dysregulation and disease severity

Sci Adv. 2022 Oct 7;8(40):eabn3777. doi: 10.1126/sciadv.abn3777. Epub 2022 Oct 7.

Abstract

Patients infected with the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) can experience life-threatening respiratory distress, blood pressure dysregulation, and thrombosis. This is thought to be associated with an impaired activity of angiotensin-converting enzyme 2 (ACE2), which is the main entry receptor of SARS-CoV-2 and which also tightly regulates blood pressure by converting the vasoconstrictive peptide angiotensin II (AngII) to a vasopressor peptide. Here, we show that a significant proportion of hospitalized patients with COVID-19 developed autoantibodies against AngII, whose presence correlates with lower blood oxygenation, blood pressure dysregulation, and overall higher disease severity. Anti-AngII antibodies can develop upon specific immune reaction to the SARS-CoV-2 proteins Spike or receptor-binding domain (RBD), to which they can cross-bind, suggesting some epitope mimicry between AngII and Spike/RBD. These results provide important insights on how an immune reaction against SARS-CoV-2 can impair blood pressure regulation.

MeSH terms

  • Angiotensin II
  • Angiotensin-Converting Enzyme 2*
  • Autoantibodies
  • Blood Pressure
  • COVID-19*
  • Epitopes / metabolism
  • Humans
  • Peptidyl-Dipeptidase A / metabolism
  • Protein Binding
  • SARS-CoV-2
  • Severity of Illness Index
  • Spike Glycoprotein, Coronavirus

Substances

  • Autoantibodies
  • Epitopes
  • Spike Glycoprotein, Coronavirus
  • spike protein, SARS-CoV-2
  • Angiotensin II
  • Peptidyl-Dipeptidase A
  • Angiotensin-Converting Enzyme 2