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Published online: 2021-08-12
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ACE gene I/D polymorphism and severity of SARS-CoV-2 infection in hospitalized patients: a metanalysis

Teodoro J. Oscanoa, Xavier Vidal, Eliecer Coto, Roman Romero-Ortuno
DOI: 10.5603/AH.a2021.0018

open access

Ahead of print
ORIGINAL PAPERS
Published online: 2021-08-12

Abstract

Background Hypertension and type 2 diabetes increase the risk of severe SARS-CoV-2 infection. On the other hand, homozygous ACE deletion polymorphism (DD) has been associated with these two diseases and risk of acute respiratory distress syndrome. Aim To conduct a metanalysis of the association between ACE gene I/D polymorphism (DD, II and DI) and severity of SARS-CoV-2 infection in hospitalized patients. Methods We searched PubMed, EMBASE and Google Scholar for studies published between January 2020 and April 2021. We included case-control studies evaluating the association between ACE I/D and severity of SARS-CoV-2 infection in hospitalized patients, were there was sufficient genotype or allele frequency data to calculate IRR (incidence rate ratio) and 95% confidence intervals (CIs). Results 5 studies were included (mean age 58.5 years and 61% men), combining to a total of 786 patients. Three studies were conducted in Caucasians. Overall, patients who had homozygous co-dominance genotype DD were at 47% higher risk of severe COVID-19 compared with II or ID (IRR: 1.47; 95% CI: 1.15-1.89; p=0.002). Conclusions The ACE DD genotype may confer a greater risk of severe COVID-19 in hospitalized patients. Further studies including more diverse ethnic groups are necessary to fully establish this association.

Abstract

Background Hypertension and type 2 diabetes increase the risk of severe SARS-CoV-2 infection. On the other hand, homozygous ACE deletion polymorphism (DD) has been associated with these two diseases and risk of acute respiratory distress syndrome. Aim To conduct a metanalysis of the association between ACE gene I/D polymorphism (DD, II and DI) and severity of SARS-CoV-2 infection in hospitalized patients. Methods We searched PubMed, EMBASE and Google Scholar for studies published between January 2020 and April 2021. We included case-control studies evaluating the association between ACE I/D and severity of SARS-CoV-2 infection in hospitalized patients, were there was sufficient genotype or allele frequency data to calculate IRR (incidence rate ratio) and 95% confidence intervals (CIs). Results 5 studies were included (mean age 58.5 years and 61% men), combining to a total of 786 patients. Three studies were conducted in Caucasians. Overall, patients who had homozygous co-dominance genotype DD were at 47% higher risk of severe COVID-19 compared with II or ID (IRR: 1.47; 95% CI: 1.15-1.89; p=0.002). Conclusions The ACE DD genotype may confer a greater risk of severe COVID-19 in hospitalized patients. Further studies including more diverse ethnic groups are necessary to fully establish this association.

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Keywords

ACE gene, I/D polymorphism; SARS-CoV-2, COVID-19; Meta-analysis

About this article
Title

ACE gene I/D polymorphism and severity of SARS-CoV-2 infection in hospitalized patients: a metanalysis

Journal

Arterial Hypertension

Issue

Ahead of print

Article type

Original paper

Published online

2021-08-12

DOI

10.5603/AH.a2021.0018

Keywords

ACE gene
I/D polymorphism
SARS-CoV-2
COVID-19
Meta-analysis

Authors

Teodoro J. Oscanoa
Xavier Vidal
Eliecer Coto
Roman Romero-Ortuno

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