ACE1-I/D Polymorphism in Patients With Severe COVID-19

Background: In several studies, insertion/deletion (I/D) polymorphism in the angiotensin-converting enzyme 1 (ACE1) gene is described as a genetic risk factor for coronavirus disease 2019 (COVID-19) infection. However, in some studies, this contribution is not confirmed. Therefore, this study aimed to evaluate the genotypic and allelic frequency of ACE1-D/I in Kurdish patients with severe COVID-19 in Iran. Methods: A total of 95 patients with PCR positive-COVID-19 were enrolled in this cross-sectional study. Genomic DNA was extracted from peripheral blood leucocytes using the salting out method. All cases were genotyped for ACE1-I/D polymorphism using polymerase chain reaction (PCR). Death percentage from COVID-19 after two months? follow-up was analyzed.?Results: Of?the 95 patients, 48 were female (50.5%) and 47 were male (49.5%) with a mean age of 61.9?18.7 years. The ID genotype was the most prevalent (52.6%) followed by DD (32.6%) and II (14.7%). The D and I allele frequencies were 58.9%, and 41.1%, respectively. The D allele frequency was higher in patients with SpO2?90% (P = 0.048). The mortality percentage was 18.9% (8 females and 10 males). The frequency of the DD, ID, and II genotypes in patients who died from COVID-19 was 27.7%, 61,1%, and 11.1%. Conclusions: Our results indicated that the ACE1- D allele can be a genetic risk factor in COVID-19 patients. Further studies on different ethnicities and geographical regions are needed to evaluate this polymorphism in COVID-19 infection.