{"doi":"10.1101/2025.02.12.25322167","title":"ACE-2-like Enzymatic Activity in COVID-19 Convalescents with Persistent Pulmonary Symptoms Associated with Immunoglobulin","abstract":"Many difficult to understand clinical features characterize COVID-19 and Post-Acute Sequelae of COVID-19 (PASC or Long COVID, LC). These can include blood pressure instability, hyperinflammation, coagulopathies, and neuropsychiatric complaints. The pathogenesis of these features remains unclear. The SARS-CoV-2 Spike protein Receptor Binding Domain (RBD) binds Angiotensin Converting Enzyme 2 (ACE2) on the surface of host cells to initiate infection. We hypothesized that some people convalescing from COVID-19 may produce anti-RBD antibodies that resemble ACE2 sufficiently to have ACE2-like catalytic activity, that is they are ACE2-like proteolytic abzymes that may help mediate the pathogenesis of COVID-19 and LC. In previous work, we showed that some people with acute COVID-19 had immunoglobulin-associated ACE2-like proteolytic activity, suggesting that some people with COVID-19 indeed produced ACE2-like abzymes. However, it remained unknown whether ACE2-like abzymes were seen only in acute COVID-19 or whether ACE2-like abzymes could also be identified in people convalescing from COVID-19. Here we show that some people convalescing from COVID-19 attending a clinic for people with persistent pulmonary symptoms also have ACE2-like abzymes and that the presence of ACE2-like catalytic activity correlates with alterations in blood pressure in an exercise test.","journal":"medRxiv","year":2025,"id":557321,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":1,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.9596,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2025-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":1203208,"name":"Frances Mehl","orcid":"0009-0005-9929-3185","position":1,"is_corresponding":false},{"id":350268,"name":"Lyndsey M. Muehling","orcid":"0000-0003-3203-3264","position":2,"is_corresponding":false},{"id":576994,"name":"Glenda Canderan","orcid":"0000-0001-8388-9930","position":3,"is_corresponding":false},{"id":733166,"name":"Kyle Enfield","orcid":null,"position":4,"is_corresponding":false},{"id":254567,"name":"Jie Sun","orcid":"0000-0002-2347-4511","position":5,"is_corresponding":false},{"id":105635,"name":"Michael T. Yin","orcid":"0000-0002-9346-9056","position":6,"is_corresponding":false},{"id":59351,"name":"Sarah J. Ratcliffe","orcid":"0000-0002-6644-8284","position":7,"is_corresponding":false},{"id":334949,"name":"Jeffrey M. Wilson","orcid":"0000-0002-5975-1760","position":8,"is_corresponding":false},{"id":328780,"name":"Alexandra Kadl","orcid":"0000-0001-6285-574X","position":9,"is_corresponding":false},{"id":350271,"name":"Judith A. Woodfolk","orcid":"0000-0002-8915-4334","position":10,"is_corresponding":false},{"id":758345,"name":"Steven L. Zeichner","orcid":"0000-0002-8922-9260","position":11,"is_corresponding":false},{"id":1203207,"name":"Yufeng Song","orcid":"0009-0001-6788-1717","position":0,"is_corresponding":true}],"reference_count":52,"raw_metadata":null,"created_at":"2026-07-19T02:55:17.435961Z","pmid":"39990545","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}