Evaluation of ACE1 I/D gene polymorphism as a prognostic molecular genetic marker of severity of COVID-19 in juvenile idiopathic arthritis

The role of ACE1 I/D gene polymorphism in predicting the severity of COVID-19 (coronavirus infection) in children with autoimmune diseases, including juvenile idiopathic arthritis (JIA), is an important aspect for determining the tactics of personalised therapy. Aim - to study the features of the clinical course of COVID-19 and allelic polymorphism of the ACE1 gene in JIA to predict the severity of coronavirus infection. Materials and methods. The course of COVID-19 was retrospectively analysed in 44 patients with JIA and 20 children without chronic somatic pathology (control group). Genomic DNA preparations were isolated and purified, which made up the Patient Biobank for genotyping at rs4646994 of the ACE1 gene. Results. In the majority (70.0%) of children with JIA, COVID-19 infection has a mild, subclinical course. Insufficient medication control of JIA activity may be a predicted risk factor for more severe COVID-19. The severity of COVID-19 is not a risk factor for exacerbation of autoimmune disease. In the study of the distribution of ACE I/D genotypes and alleles in children with JIA depending on the severity of COVID-19, no significant difference in the groups was obtained. The DD genotype was significantly more common in the group of children with mild COVID-19 without rheumatological pathology and there was a tendency to increase the frequency of the genotype (II insertion) among patients with JIA who had mild COVID-19 compared with the control group. Conclusions. In the mild course of COVID-19 in patients with JIA, the DI genotype at the ACE1 rs4646994 gene was significantly more frequent and there is a tendency to increase the frequency of the genotype (II insertion). Such genotypes in patients with JIA may lead to an imbalance of the components of the renin-angiotensin system, but, on the other hand, they can be considered as protective, due to which the group of children with JIA does not develop severe COVID-19. The research was carried out in accordance with the principles of the Declaration of Helsinki. The study protocol was approved by the Local Ethics Committees of the institutions indicated in the work. Informed consent of the child and child's parents was obtained for the research. No conflict of interest was declared by the authors.