Evaluation of the renin-angiotensin-aldosterone system and neuroendocrine stress axis in COVID-19 suspicious outpatients tested for SARS-CoV2 RT-PCR referred to 16-hour comprehensive health centers in Abadan County: A cross-sectional case-control study

RAAS could play a substantial role in the pathophysiology of COVID-19. Also, the dynamics of the HPA axis may have changed in COVID-19. So, we aimed to assess RAAS and the HPA axis in COVID-19 suspicious outpatients referred to 16-hour comprehensive health centers in Abadan. Demographic and clinical data were collected. Serum cortisol and aldosterone measurements and blood grouping were done. Clinical symptoms of the positive PCR group were followed up on for four weeks. SPO2 was significantly lower in the positive PCR group, but the respiratory rate was significantly higher (P= 0.03 and P=0.001, respectively). Outpatients with the O blood group showed higher levels of cortisol in comparison to those with A and AB blood groups (P= 0.003 and P= 0.03 respectively) in the positive PCR group. Negative PCR individuals with the AB blood type had significantly higher levels of cortisol compared with those who had A (P= 0.02) and O (P=0.03) blood types. We saw significantly higher levels of aldosterone in males of the negative PCR group in comparison with females (P= 0.05). Cortisol (OR= 0.937, P= 0.033) and aldosterone (OR= 1.005, P= 0.020) levels had a decreasing and increasing effect on the chances of respiratory symptoms occurring over time, respectively. Also, over time, women were twice as likely as men to develop neurologic symptoms (OR= 0.530, P= 0.015). Cortisol and aldosterone are associated with the chance of respiratory symptoms occurring over time. However, the levels of these two markers do not seem to be related to the lower grades of COVID-19.