Key result
The ACE1 D/D genotype was significantly more prevalent in children and adolescents with COVID-19 compared to healthy controls (55% vs 28%, OR 2.4), indicating increased susceptibility to infection.
Why the study?
Data on the renin-angiotensin system and ACE1 and ACE2 in pediatric COVID-19 cases were sparse.
Is the ACE1 I/D polymorphism associated with susceptibility to COVID-19 in Egyptian children and adolescents?
Case-Control (n=920)
Yes
Is the ACE1 I/D polymorphism associated with susceptibility to COVID-19 in Egyptian children and adolescents?
The ACE1 D/D genotype and Deletion allele are associated with increased susceptibility to and severity of COVID-19 in Egyptian children and adolescents.
Answers are grounded in this paper and cite their sources.
May signal genetic susceptibility in Egyptian youth; hypothesis-generating and requires confirmation before any clinical consideration.
BACKGROUND: Given the sparse data on the renin-angiotensin system (RAS) and its biological effector molecules ACE1 and ACE2 in pediatric COVID-19 cases, we investigated whether the ACE1 insertion/deletion (I/D) polymorphism could be a genetic marker for susceptibility to COVID-19 in Egyptian children and adolescents. METHODS: This was a case-control study included four hundred sixty patients diagnosed with COVID-19, and 460 well-matched healthy control children and adolescents. The I/D polymorphism (rs1799752) in the ACE1 gene was genotyped by polymerase chain reaction (PCR), meanwhile the ACE serum concentrations were assessed by ELISA. RESULTS: The ACE1 D/D genotype and Deletion allele were significantly more represented in patients with COVID-19 compared to the control group (55% vs. 28%; OR = 2.4; [95% CI: 1.46-3.95]; for the DD genotype; P = 0.002) and (68% vs. 52.5%; OR: 1.93; [95% CI: 1.49-2.5] for the D allele; P = 0.032). The presence of ACE1 D/D genotype was an independent risk factor for severe COVID-19 among studied patients (adjusted OR: 2.6; [95% CI: 1.6-9.7]; P < 0.001. CONCLUSIONS: The ACE1 insertion/deletion polymorphism may confer susceptibility to SARS-CoV-2 infection in Egyptian children and adolescents. IMPACT: Recent studies suggested a crucial role of renin-angiotensin system and its biological effector molecules ACE1 and ACE2 in the pathogenesis and progression of COVID-19. To our knowledge, ours is the first study to investigate the association of ACE1 I/D polymorphism and susceptibility to COVID-19 in Caucasian children and adolescents. The presence of the ACE1 D/D genotype or ACE1 Deletion allele may confer susceptibility to SARS-CoV-2 infection and being associated with higher ACE serum levels; may constitute independent risk factors for severe COVID-19. The ACE1 I/D genotyping help design further clinical trials reconsidering RAS-pathway antagonists to achieve more efficient targeted therapies.
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Boraey et al. (2024) conducted a case-control in COVID-19 (n=920). ACE1 D/D genotype vs. Healthy controls was evaluated on Susceptibility to COVID-19 (presence of ACE1 D/D genotype) (OR 2.4, 95% CI 1.46-3.95, p=0.002). The ACE1 D/D genotype was significantly more prevalent in children and adolescents with COVID-19 compared to healthy controls (55% vs 28%, OR 2.4), indicating increased susceptibility to infection.
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