ACE I/D polymorphism in Czech first-wave SARS-CoV-2-positive survivors

• Published in: Clinica chimica acta Vol. 519; pp. 206 - 209
• Main Authors: Hubacek, Jaroslav A., Dusek, Ladislav, Majek, Ondrej, Adamek, Vaclav, Cervinkova, Tereza, Dlouha, Dana, Adamkova, Vera
• Format: Journal Article
• Language: English
• Published: Netherlands Elsevier B.V 01.08.2021
• Subjects: ACE; China; COVID-19; Czech Republic; Humans; Insertion/deletion; Peptidyl-Dipeptidase A - genetics; Polymorphism; SARS-CoV-2; Survivors; Czech Republic; China; COVID-19; ACE; Insertion/deletion; Polymorphism
• ISSN: 0009-8981; 1873-3492; 1873-3492
• DOI: 10.1016/j.cca.2021.04.024

•Severe acute respiratory syndrome coronavirus 2 rapidly spread to all continents.•Genetic seems to be important for the resistance to and mortality of COVID-19.•ACE I/D polymorphism has the potential to affect infection symptoms and mortality.•ACE I/I homozygotes were more common in COVID-19 patients that in controls.•The difference was driven just by the symptomatic subjects. Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) rapidly spread from China in 2019/2020 to all continents. Significant geographical and ethnic differences were described, and host genetic background seems to be important for the resistance to and mortality of COVID-19. Angiotensin-converting enzyme (ACE) insertion/deletion (I/D) polymorphism (rs4646994) is one of the candidates with the potential to affect infection symptoms and mortality. In our study, we successfully genotyped 408 SARS-CoV-2-positive COVID-19 survivors (163 asymptomatic and 245 symptomatic) and compared them with a population-based DNA bank of 2,559 subjects. The frequency of ACE I/I homozygotes was significantly increased in COVID-19 patients compared with that in controls (26.2% vs. 21.2%; P = 0.02; OR [95% CI] = 1.55 [1.17–2.05]. Importantly, however, the difference was driven just by the symptomatic subjects (29.0% vs. 21.2% of the I/I homozygotes; P = 0.002; OR [95% CI] = 1.78 [1.22–2.60]). The genotype distribution of the ACE genotypes was almost identical in population controls and asymptomatic SARS-CoV-2-positive patients (P = 0.76). We conclude that ACE I/D polymorphism could have the potential to predict the severity of COVID-19, with I/I homozygotes being at increased risk of symptomatic COVID-19.