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The Anatolian Journal of Cardiology Are angiotensin converting enzyme (ACE1/ACE2) gene variants associated with the clinical severity of COVID-19 pneumonia? A single-center cohort study [Anatol J Cardiol]
Anatol J Cardiol. Ahead of Print: AJC-21624 | DOI: 10.5152/AnatolJCardiol.2021.502

Are angiotensin converting enzyme (ACE1/ACE2) gene variants associated with the clinical severity of COVID-19 pneumonia? A single-center cohort study

Serdal Baştuğ1, Büşranur Çavdarlı2, Aliye Baştuğ3, İrfan Şencan4, Ebru Tunçez2, Esra Yakışık Çakır5, Nizamettin Kemirtlek6, Cihad Sakar7, Deniz Erdem8, Gülay Güleç Ceylan9, Işıl Özkoçak Turan8, Sümeyye Kazancıoğlu6, Hürrem Bodur3
1Department of Cardiology, Ankara Yıldırım Beyazıt University, Ankara City Hospital; Ankara-Turkey
2Department of Medical Genetics, Ankara City Hospital; Ankara-Turkey
3Department of Infectious Disease and Clinical Microbiology, Health Science University Turkey, Ankara City Hospital; Ankara-Turkey
4Department of Infectious Disease and Clinical Microbiology, Health Science University Turkey, Ankara Dışkapı Yıldırım Beyazıt Hospital; Ankara-Turkey
5Department of Anesthesiology and Reanimation, Critical Care Medicine, Ankara City Hospital; Ankara-Turkey
6Department of Infectious Disease and Clinical Microbiology, Ankara City Hospital; Ankara-Turkey
7Department of Infectious Disease and Clinical Microbiology, Ankara Dışkapı Yıldırım Beyazıt Hospital; Ankara-Turkey
8Department of Anesthesiology and Reanimation, Critical Care Medicine, Health Science University Turkey, Ankara City Hospital; Ankara-Turkey
9Department of Medical Genetics, Ankara Yıldırım Beyazıt University, Ankara City Hospital; Ankara-Turkey

Objective: The impact of the coronavirus disease 2019 (COVID-19) pandemic has been unceasingly ongoing worldwide. Recent bioinformatics analysis and epidemiologic studies have highlighted that the functional polymorphisms on the angiotensin converting enzyme (ACE) gene may have an impact on the clinical progress of COVID-19. In this study, we aimed to determine the impact of the ACE1 gene I/D polymorphism and ACE2 peptidase-2 domain variants on disease severity.
Methods: Hundred patients with confirmed COVID-19 related pneumonia [50 patients with severe disease in intensive care unit (ICU) and 50 patients not in ICU] were compared on the basis of genetic and clinical characteristics. Genomic DNA was purified from peripheral blood lymphocytes with an automated QIA symphony DSP DNA Mini-Kit. The Sanger sequencing analysis was performed. The frequencies of ACE1 gene polymorphism and ACE2 PD variants were compared in patients hospitalized in ICU and those not in ICU. The Statistical Package for Social Sciences version 22.0 was used for statistical analysis.
Results: The sequencing analysis of the ACE2 gene exon 1 and 2 revealed none of the polymorphisms investigated or any other variants in the present cohort. The frequencies of the ACE1 ID, DD, and II genotypes were 51%, 31%, and 18%, respectively. The frequency of the D allele was similar between the ICU and non-ICU groups (50.4% versus 49.6%). Older age and the presence of advanced stage radiologic abnormalities on admission were detected as independent predictors of ICU requirement.
Conclusion: No effect of any ACE1 gene polymorphism on predicting ICU requirement was detected. To the best of our knowledge, this is the first study investigating the impact of ACE gene polymorphisms on clinical severity of COVID-19 in a Turkish cohort.

Keywords: angiotensin converting enzyme, gene polymorphism, coronavirus disease 2019 severity, severe acute respiratory syndrome coronavirus 2



Corresponding Author: Serdal Baştuğ
Manuscript Language: English