ACE2 and TMPRSS2 SNPs as Determinants of Susceptibility to, and Severity of, a COVID-19 Infection

• Published in: British journal of biomedical science 2022-01, Vol.79, p.10238
• Main Authors: Abdelsattar, S, Kasemy, Z A, Ewida, S F, Abo-Elsoud, R A A, Zytoon, A A, Abdelaal, G A, Abdelgawad, A S, Khalil, F O, Kamel, H F M
• Format: Article
• Language: English
• Subjects: Angiotensin-Converting Enzyme 2 - genetics; Case-Control Studies; COVID-19 - genetics; Ferritins; Health Archive; Humans; Hypertension; Polymorphism, Single Nucleotide; SARS-CoV-2; Serine Endopeptidases - genetics
• ISSN: 2474-0896; 0967-4845; 2474-0896
• DOI: 10.3389/bjbs.2021.10238

Genetic risk factors may be related to the infectivity and severity of SARS-CoV-2 infection. Angiotensin-converting enzyme 2 (ACE2) and host transmembrane serine protease (TMPRSS2) have key role in viral cell entrance and priming. This case-control study on 147 healthy controls and 299 COVID-19 patients identified potential determinants and risk factors, including gene polymorphism involved in the severity (mild, moderate, severe) of COVID-19 disease defined by CORAD radiological criteria. The ACE2 s2285666 and TMPRSS2 rs12329760 SNPs were significantly linked with COVID-19 disease severity, as were certain co-morbidities (hypertension, heart disease) and laboratory parameters. Both SNPs were amongst the highest predictors of disease severity: TMPRSS2 rs12329760 CT + TT [odds ratio (95% CI) 17.6 (5.1-61.10), ACE2 rs2285666 CT + TT 9.9 (3.2-30.9), both < 0.001]. There was an increase in the expression of genotype frequencies of ACE2 rs2285666 and TMPRSS2 rs1232976 (TT), (CT + TT), and (T) allele in severe COVID-19 group compared to control and mild groups. Disease severity was also linked to elevated CRP, ferritin and D-dimer, and lower lymphocytes and platelet count (all < 0.001). ACE2 rs2285666 and TMPRSS2 rs12329760 SNPs, in addition to lymphocyte count, CRP, D-dimers, ferritin, and hypertension, are predictors of COVID-19 disease severity.