open access

Vol 25, No 3 (2021)
Original paper
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 meta-analysis

Teodoro J. Oscanoa12, Xavier Vidal3, Eliecer Coto456, Roman Romero-Ortuno78
·
Arterial Hypertension 2021;25(3):112-118.
Affiliations
  1. Facultad de Medicina Humana, Universidad de San Martín de Porres, Lima, Perú, Peru
  2. Facultad de Medicina, Universidad Nacional Mayor de San Marcos, Lima, Perú, Peru
  3. Clinical Pharmacology Department, Vall d’Hebron Hospital, Barcelona, Spain
  4. Genética Molecular, Hospital Universitario Central Asturias, Oviedo, Oviedo, Spain
  5. Instituto de Investigación Sanitaria del Principado de Asturias, ISPA, Oviedo, Spain; Universidad de Oviedo, Oviedo, Spain
  6. Red de Investigación Renal (REDINREN), Madrid, Spain
  7. Discipline of Medical Gerontology, Mercer’s Institute for Successful Ageing, St. James’s Hospital, Dublin, Ireland
  8. Global Brain Health Institute, Trinity College Dublin, Ireland

open access

Vol 25, No 3 (2021)
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. The aim of the study was to conduct a meta-analysis of the association between ACE gene I/D polymorphism (DD, II and DI) and severity of SARS-CoV-2 infection in hospitalized patients.

Material and 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: Five studies were included (mean age 58.5 years and 61% men), combining to a total of 786 patients. Four 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. The aim of the study was to conduct a meta-analysis of the association between ACE gene I/D polymorphism (DD, II and DI) and severity of SARS-CoV-2 infection in hospitalized patients.

Material and 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: Five studies were included (mean age 58.5 years and 61% men), combining to a total of 786 patients. Four 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 meta-analysis

Journal

Arterial Hypertension

Issue

Vol 25, No 3 (2021)

Article type

Original paper

Pages

112-118

Published online

2021-08-12

Page views

11925

Article views/downloads

841

DOI

10.5603/AH.a2021.0018

Bibliographic record

Arterial Hypertension 2021;25(3):112-118.

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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