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Altoukhi SM, Zamkah MM, Alharbi RA, Alghamdi SK, Aldawsari LS, Tarabulsi M, Rizk H, Sandokji Y. Understanding the effects of COVID-19 on patients with diabetic nephropathy: a systematic review. Ann Med Surg (Lond) 2024; 86:3478-3486. [PMID: 38846830 PMCID: PMC11152851 DOI: 10.1097/ms9.0000000000002053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2023] [Accepted: 03/30/2024] [Indexed: 06/09/2024] Open
Abstract
Background Diabetic nephropathy is one of the consequences of diabetes mellitus that causes a continuous decline in the eGFR. After the COVID-19 pandemic, studies have shown that patients with diabetic nephropathy who had contracted COVID-19 have higher rates of morbidity and disease progression. The aim of this study was to systematically review the literature to determine and understand the effects and complications of SARS-CoV-2 on patients with diabetic nephropathy. Materials and methods The authors' research protocol encompassed the study selection process, search strategy, inclusion/exclusion criteria, and a data extraction plan. A systematic review was conducted by a team of five reviewers, with an additional reviewer assigned to address any discrepancies. To ensure comprehensive coverage, the authors employed multiple search engines including PubMed, ResearchGate, ScienceDirect, SDL, Ovid, and Google Scholar. Results A total of 14 articles meeting the inclusion criteria revealed that COVID-19 directly affects the kidneys by utilizing ACE2 receptors for cell entry, which is significant because ACE2 receptors are widely expressed in the kidney. Conclusion COVID-19 affects kidney health, especially in individuals with diabetic nephropathy. The mechanisms include direct viral infection and immune-mediated injury. Early recognition and management are vital for improving the outcomes.
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Affiliation(s)
| | | | | | | | | | | | - Hisham Rizk
- General Surgery, Faculty of Medicine, University of Jeddah, Jeddah, Saudi Arabia
| | - Yousif Sandokji
- General Surgery, Faculty of Medicine, University of Jeddah, Jeddah, Saudi Arabia
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Duah-Quashie NO, Opoku-Agyeman P, Lanza M, Rubio JM. Polymorphisms in the human angiotensin converting enzyme gene (ACE) linked to susceptibility of COVID-19 and malaria infections in the Ghanaian population. INFECTION, GENETICS AND EVOLUTION : JOURNAL OF MOLECULAR EPIDEMIOLOGY AND EVOLUTIONARY GENETICS IN INFECTIOUS DISEASES 2024; 119:105568. [PMID: 38367677 DOI: 10.1016/j.meegid.2024.105568] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/16/2024] [Revised: 01/29/2024] [Accepted: 02/09/2024] [Indexed: 02/19/2024]
Abstract
Genetic variations in the human angiotensin converting enzyme gene (ACE) influence ACE enzyme expression levels in humans and subsequently influence both communicable and non-communicable disease outcomes. More recently, polymorphisms in this gene have been linked to susceptibility and outcomes of infectious diseases such as the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and malaria infections. This study is the first to investigate the genetic diversity of ACE and ACE2 polymorphisms in the Ghanaian population. Archived filter blood blot samples from malaria patients aged ≤9 years were used. Molecular analysis for the detection of ACE rs4646994 (I/D), ACE2 rs2106809 (C/T) and rs2285666 (G/A) alleles as well as ACE2 exons 1-4 polymorphisms was conducted on 300 samples. The D allele (54%,162/300) was the most dominant polymorphism observed in the ACE rs4646994 gene whilst the G (68%, 204/300) and T alleles (59.3%,178/300) were the most frequent ACE2 rs2285666 and rs2106809 polymorphisms observed. For the 300 samples sequenced for ACE2 exons 1-4, analyses were done on 268, 282 and 137 quality sequences for exons 1, 2 and 3-4 respectively. For exon 1, the mutation D38N (2.2%; 6/268) was the most prevalent. The S19P and E37K mutations previously reported to influence COVID-19 infections were observed at low frequencies (0.4%, 1/268 each). No mutations were observed in exon 2. The N121K/T variants were the most seen in exons 3-4 at frequencies of 5.1% (K121, 7/137) and 2.9% (T121, 4/137) respectively. Most of the variants observed in the exons were novel compared to those reported in other populations in the world. This is the first study to investigate the genetic diversity of ACE and ACE2 genes in Ghanaians. The observation of novel mutations in the ACE2 gene is suggesting selection pressure. The importance of the mutations for communicable and non-communicable diseases (malaria and COVID-19) are further discussed.
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Affiliation(s)
- Nancy O Duah-Quashie
- Department of Epidemiology, Noguchi Memorial Institute for Medical Research, College of Health Sciences, University of Ghana, Accra, Ghana.
| | - Philip Opoku-Agyeman
- Department of Epidemiology, Noguchi Memorial Institute for Medical Research, College of Health Sciences, University of Ghana, Accra, Ghana
| | - Marta Lanza
- Malaria & Parasitic Emerging Diseases Laboratory, National Microbiology Center, Instituto de Salud Carlos III, Majadahonda, Madrid, Spain
| | - Jose Miguel Rubio
- Malaria & Parasitic Emerging Diseases Laboratory, National Microbiology Center, Instituto de Salud Carlos III, Majadahonda, Madrid, Spain; Biomedical Research Networking Center of Infectious Diseases (CIBERINFEC), Instituto de Salud Carlos III, Madrid, Spain
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Al Otaibi T, Nagib A, Nair P, Halim MA, Khaled M, Hammad MA, Mahmoud TS, Sobhy I, Zakaria Z, Atta A, Deraz A, Mostafa A, Abuelmagd M, Shaker M, Alserwy N, Fyyad Z, Rida S, Aboatya H, Adel M, Balaha M, Atea K, Gheith O. Acute Kidney Injury Among COVID-19-Positive Patients Is Associated With Higher Mortality: A Single-Center Experience. EXP CLIN TRANSPLANT 2024; 22:290-298. [PMID: 38385415 DOI: 10.6002/ect.mesot2023.p98] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/23/2024]
Abstract
OBJECTIVES Renal complications of COVID-19 are not yet well studied. We aimed to evaluate acute kidney injury prevalence among hospitalized patients with COVID-19 infection and explore its effect on patient outcomes. MATERIALS AND METHODS We retrospectively evaluated 586 hospitalized patients with COVID-19. Of these patients, 267 (45.5%) developed acute kidney injury, as classified according to the Kidney Disease Improving Global Outcomes guidelines. We compared this group with 319 patients (54.5%) without acute kidney injury. RESULTS Most patients in both study groups were men; mean age was 60.8 ± 14 versus 51.7 ± 16 years. Comorbid conditions that were substantially predominant among patients with acute kidney injury were diabetes mellitus (64% vs 42.9%), hypertension (72.6% vs 43.5%), and ischemic heart disease (25% vs 14.7%). Fever, cough, shortness of breath, and dehydration were the main presentations among patients with acute kidney injury, and patients in this group had greater prevalence of radiological findings concordant with COVID-19 (86.8% vs 59.8%). Sepsis, volume depletion, shock, arrhythmias, and acute respiratory distress syndrome were higher in patients with acute kidney injury. Anticoagulation (85% vs 59.2%), vasopressors, plasma infusions, antimicrobials, and steroids were more frequently used in patients with acute kidney injury. More patients with acute kidney injury had acute respiratory failure requiring mechanical ventilation (62.3% vs 32.9%), with higher overall mortality rate (63.2% vs 31.1%). CONCLUSIONS We found more frequent prevalence of acute kidney injury associated with severe COVID-19 than shown in reports from Chinese, European, and North American cohorts. Patients with COVID-19 who developed acute kidney injury had risk factors such as hypertension and diabetes, greater need for mechanical ventilation, were males, and were older age. Mortality was high in this population, especially among older patients and those who developed Kidney Disease Improving Global Outcomes stage 3 disease.
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Samet M, Yazdi M, Tajamolian M, Beygi M, Sheikhha MH, Hoseini SM. The Effect of Angiotensin-Converting Enzyme Insertion/Deletion Polymorphism on the Severity and Death Rate of COVID-19 in Iranian Patients. Biochem Genet 2023:10.1007/s10528-023-10614-3. [PMID: 38145438 DOI: 10.1007/s10528-023-10614-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2023] [Accepted: 11/22/2023] [Indexed: 12/26/2023]
Abstract
The study was designed to assess the association of ACE I/D polymorphism with the severity and prognosis of COVID-19 in the Iranian population. Hence, 186 adult patients were categorized into three clinical groups based on the severity of COVID-19: 1) Outpatients or mildly symptomatic patients as control (n = 71); 2) Hospitalized patients or severe symptomatic cases (n = 53); 3) Inpatients led to ICU/death or critically ill patients needed mechanical ventilation (n = 62). The possible association of ACE I/D polymorphism with the risk of comorbidities and serum level of C-reactive protein was evaluated in two severe cases. The results showed that the frequency of D and I alleles are 69.35% and 30.65%, respectively, in the total population. The analysis of allelic frequencies via Fisher's exact test confirmed significantly higher frequency of D allele in both severe groups than that in the mild one, 78.31% in Hospitalized patients (OR = 2.56; 95% CI 1.46 to 4.46; p-value = 0.0011) and 74.19% in Inpatients led to ICU/death (OR = 2.04; 95% CI = 1.22 to 3.43; p-value = 0.0094) compared to 58.45% in Outpatients. The results of genotype proportions displayed an association between COVID-19 severity and DD genotype. Overall, our findings in Iranian patients supported the undeniable role of the DD genotype in the intensity of the disease, comparable to other populations. Furthermore, there is no definite evidence regarding the protective effect of the I allele in our inquiry.
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Affiliation(s)
- Mohammad Samet
- Departments of Internal Medicine, Faculty of Medicine, Shahid Sadoughi University of Medical Sciences and Health Services, Yazd, Iran
| | - Mehran Yazdi
- Departments of Internal Medicine, Faculty of Medicine, Shahid Sadoughi University of Medical Sciences and Health Services, Yazd, Iran
| | - Masoud Tajamolian
- Medical Genetics Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Mahdi Beygi
- Medical Genetics Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Mohammad Hasan Sheikhha
- Research and Clinical Center for Infertility, Yazd Reproductive Sciences Institute, Shahid Sadoughi University of Medical Sciences and Health Services, Yazd, Iran
| | - Seyed Mehdi Hoseini
- Abortion Research Center, Yazd Reproductive Sciences Institute, Shahid Sadoughi University of Medical Sciences and Health Services, Yazd, Iran.
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Luoyi H, Yan P, Qihong F. Relationship between Angiotensin-Converting Enzyme Insertion/Deletion Polymorphism and the Risk of COVID-19: A Meta-Analysis. J Renin Angiotensin Aldosterone Syst 2023; 2023:3431612. [PMID: 38058963 PMCID: PMC10697777 DOI: 10.1155/2023/3431612] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2022] [Revised: 08/13/2023] [Accepted: 11/15/2023] [Indexed: 12/08/2023] Open
Abstract
Introduction Research shows the correlation between angiotensin-converting enzyme (ACE) deletion and insertion (D/I) polymorphism and COVID-19 risk; yet, conclusive evidence is still lacking. Thus, a meta-analysis of relevant articles was performed to more accurately estimate the relationship of ACE I/D polymorphism with the risk of COVID-19. Material and Methods. Relevant literature from the PubMed database was systematically reviewed, and odds ratios (ORs) and associated 95% confidence intervals (CIs) were measured. Additionally, the metapackage from Stata version 15.0 was used for statistical analysis. Results The meta-analysis eventually contained 8 studies, including 1362 COVID-19 cases and 4312 controls. Based on the data, the ACE I/D polymorphism did not show an association with COVID-19 risk (D vs. I: OR = 1.25, 95% CI = 0.96-1.64; DD vs. II: OR = 1.89, 95% CI = 0.95-3.74; DI vs. II: OR = 1.75, 95% CI = 0.92-3.31; dominant model: OR = 1.88, 95% CI = 0.99-3.53; and recessive model: OR = 1.24, 95% CI = 0.81-1.90). Further, subgroup analyses stratified based on case proved that the ACE D allele demonstrated an association with increasing risk of COVID-19 severity (D vs. I: OR = 1.64, 95% CI = 1.01-2.66; DD vs. II: OR = 4.62, 95% CI = 2.57-8.30; DI vs. II: OR = 3.07, 95% CI = 1.75-5.38; dominant model: OR = 3.74, 95% CI = 2.15-6.50; and recessive model: OR = 1.28, 95% CI = 0.46-3.51). Conclusions The ACE D allele was clearly related to an enhanced risk of COVID-19 severity. Hence, it is imperative to take into account the influence of genetic factors during the development of future vaccines.
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Affiliation(s)
- Hu Luoyi
- Department of Pediatrics, The First Affiliated Hospital of Yangtze University, Jingzhou, Hubei Province, China
| | - Pan Yan
- Department of Pediatrics, The First Affiliated Hospital of Yangtze University, Jingzhou, Hubei Province, China
| | - Fan Qihong
- Department of Pediatrics, The First Affiliated Hospital of Yangtze University, Jingzhou, Hubei Province, China
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Blank JA, Armstrong-Hough M, Valley TS. Disparities among patients with respiratory failure. Curr Opin Crit Care 2023; 29:493-504. [PMID: 37641499 PMCID: PMC10599128 DOI: 10.1097/mcc.0000000000001079] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/31/2023]
Abstract
PURPOSE OF REVIEW Disparities are common within healthcare, and critical illness is no exception. This review summarizes recent literature on health disparities within respiratory failure, focusing on race, ethnicity, socioeconomic status, and sex. RECENT FINDINGS Current evidence indicates that Black patients have higher incidence of respiratory failure, while the relationships among race, ethnicity, and mortality remains unclear. There has been renewed interest in medical device bias, specifically pulse oximetry, for which data demonstrate patients with darker skin tones may be at risk for undetected hypoxemia and worse outcomes. Lower socioeconomic status is associated with higher mortality, and respiratory failure can potentiate socioeconomic inequities via illness-related financial toxicity. Literature on sex-based disparities is limited; however, evidence suggests males receive more invasive care, including mechanical ventilation. SUMMARY Most studies focused on disparities in incidence and mortality associated with respiratory failure, but few relied on granular clinical data of patients from diverse backgrounds. Future studies should evaluate processes of care for respiratory failure that may mechanistically contribute to disparities in order to develop interventions that improve outcomes.
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Affiliation(s)
| | - Mari Armstrong-Hough
- New York University School of Global Public Health, Department of Social & Behavioral Sciences, Department of Epidemiology
| | - Thomas S. Valley
- University of Michigan, Department of Internal Medicine, Division of Pulmonary and Critical Care Medicine
- VA Center for Clinical Management Research, Ann Arbor, Michigan
- Institute for Healthcare Policy and Innovation, University of Michigan
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Elbasan O, Bayram F, Yazan CD, Apaydın T, Dashdamirova S, Polat H, Arslan E, Yılmaz İ, Karimi N, Şengel BE, Yılmaz SS, Çelik ÖF, Ata P, Haklar G, Gözü H. Angiotensin-Converting Enzyme (ACE) level, but not ACE gene polymorphism, is associated with prognosis of COVID-19 infection: Implications for diabetes and hypertension. PLoS One 2023; 18:e0288338. [PMID: 37432962 DOI: 10.1371/journal.pone.0288338] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2023] [Accepted: 06/23/2023] [Indexed: 07/13/2023] Open
Abstract
BACKGROUND The renin-angiotensin-aldosterone system was shown to be activated in severe COVID-19 infection. We aimed to investigate the relationship between angiotensin converting enzyme (ACE) levels, ACE gene polymorphism, type 2 diabetes (T2DM), and hypertension (HT) and the prognosis of COVID-19 infection. METHODS This cross-sectional study analyzed the clinical features of adult patients with SARS-CoV-2 infection. ACE gene analysis and ACE level measurements were performed. The patients were grouped according to ACE gene polymorphism (DD, ID or II), disease severity (mild, moderate, or severe), and the use of dipeptidyl peptidase-4 enzyme inhibitor (DPP4i), ACE-inhibitor (ACEi) or angiotensin receptor blocker (ARB). Intensive care unit (ICU) admissions and mortality were also recorded. RESULTS A total of 266 patients were enrolled. Gene analysis detected DD polymorphism in the ACE 1 gene in 32.7% (n = 87), ID in 51.5% (n = 137), and II in 15.8% (n = 42) of the patients. ACE gene polymorphisms were not associated with disease severity, ICU admission, or mortality. ACE levels were higher in patients who died (p = 0.004) or were admitted to the ICU (p<0.001) and in those with severe disease compared to cases with mild (p = 0.023) or moderate (p<0.001) disease. HT, T2DM, and ACEi/ARB or DPP4i use were not associated with mortality or ICU admission. ACE levels were similar in patients with or without HT (p = 0.374) and with HT using or not using ACEi/ARB (p = 0.999). They were also similar in patients with and without T2DM (p = 0.062) and in those with and without DPP4i treatment (p = 0.427). ACE level was a weak predictor of mortality but an important predictor of ICU admission. It predicted ICU admission in total (cutoff value >37.092 ng/mL, AUC: 0.775, p<0.001). CONCLUSION Our findings suggest that higher ACE levels, but not ACE gene polymorphism, ACEi/ARB or DPP4i use, were associated with the prognosis of COVID-19 infection. The presence of HT and T2DM and ACEi/ARB or DPP4i use were not associated with mortality or ICU admission.
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Affiliation(s)
- Onur Elbasan
- Department of Endocrinology and Metabolism, Marmara University Faculty of Medicine, Istanbul, Turkey
| | - Feyza Bayram
- Department of Medical Genetics, Marmara University Faculty of Medicine, Istanbul, Turkey
| | - Ceyda Dinçer Yazan
- Department of Endocrinology and Metabolism, Marmara University Faculty of Medicine, Istanbul, Turkey
| | - Tuğçe Apaydın
- Department of Endocrinology and Metabolism, Marmara University Faculty of Medicine, Istanbul, Turkey
| | - Saida Dashdamirova
- Department of Endocrinology and Metabolism, Marmara University Faculty of Medicine, Istanbul, Turkey
| | - Hamza Polat
- Department of Medical Genetics, Marmara University Faculty of Medicine, Istanbul, Turkey
| | - Ebru Arslan
- Department of Medical Genetics, Marmara University Faculty of Medicine, Istanbul, Turkey
| | - İpek Yılmaz
- Department of Medical Genetics, Marmara University Faculty of Medicine, Istanbul, Turkey
| | - Nastaran Karimi
- Department of Medical Genetics, Marmara University Faculty of Medicine, Istanbul, Turkey
| | - Buket Ertürk Şengel
- Department of Infectious Diseases and Microbiology, Marmara University Faculty of Medicine, Istanbul, Turkey
| | - Sultan Seval Yılmaz
- Department of Biochemistry, Marmara University Faculty of Medicine, Istanbul, Turkey
| | - Ömer Faruk Çelik
- Department of Biochemistry, Marmara University Faculty of Medicine, Istanbul, Turkey
| | - Pınar Ata
- Department of Medical Genetics, Marmara University Faculty of Medicine, Istanbul, Turkey
| | - Goncagül Haklar
- Department of Biochemistry, Marmara University Faculty of Medicine, Istanbul, Turkey
| | - Hülya Gözü
- Department of Endocrinology and Metabolism, Marmara University Faculty of Medicine, Istanbul, Turkey
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8
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Çobanogullari H, Evren EU, Evren H, Suer K, Balcioglu O, Ergoren MC. Strong association between angiotensin-converting enzyme gene InDel polymorphism and COVID-19 diseases. MEDICINA CLINICA (ENGLISH ED.) 2023; 160:489-494. [PMID: 37309467 PMCID: PMC10250597 DOI: 10.1016/j.medcle.2022.11.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/25/2022] [Accepted: 11/15/2022] [Indexed: 06/14/2023]
Abstract
Background and Objectives The COVID-19 pandemic that emerged in China in late 2019 and spread rapidly around the world. There is evidence that COVID-19 infection can be influenced by genetic variations in the host. The aim of this study was to investigate the association between ACE InDel polymorphism and COVID-19 in Northern Cyprus. Patients and methods This study included 250 patients diagnosed with COVID-19 and 371 healthy controls. Genotyping for the ACE InDel gene polymorphism was performed by polymerase chain reaction. Results The frequency of ACE DD homozygotes was significantly increased in COVID-19 patients compared to the control group (p = 0.022). The difference in the presence of the D allele between the patient and control groups was statistically significant (57.2% and 50.67%, respectively, p < 0.05). Individuals with the genotype II were found to have a higher risk of symptomatic COVID-19 (p = 0.011). In addition, chest radiographic findings were observed more frequently in individuals with the genotype DD compared to individuals with the genotypes ID and II (p = 0.005). A statistically significant difference was found when the time of onset of symptoms for COVID-19 and duration of treatment were compared with participants' genotypes (p = 0.016 and p = 0.014, respectively). The time of onset of COVID-19 was shorter in individuals with the genotype DD than in individuals with the genotype II, while the duration of treatment was longer. Conclusion In conclusion, the ACE I/D polymorphism has the potential to predict the severity of COVID-19.
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Affiliation(s)
- Havva Çobanogullari
- Department of Molecular Medicine, Institute of Graduate Studies, Near East University, Nicosia, Cyprus
- Department of Medical Genetics, Faculty of Medicine, Near East University, Nicosia, Cyprus
| | - Emine Unal Evren
- Department of Clinical Microbiology and Infectious Diseases, Faculty of Medicine, University of Kyrenia, Kyrenia, Cyprus
- Department of Medical Genetics, Faculty of Medicine, Near East University, Nicosia, Cyprus
| | - Hakan Evren
- Department of Clinical Microbiology and Infectious Diseases, Faculty of Medicine, University of Kyrenia, Kyrenia, Cyprus
- Department of Medical Genetics, Faculty of Medicine, Near East University, Nicosia, Cyprus
| | - Kaya Suer
- Department of Medical Microbiology and Infectious Diseases, Faculty of Medicine, Near East University, Nicosia, Cyprus
- Department of Medical Genetics, Faculty of Medicine, Near East University, Nicosia, Cyprus
| | - Ozlem Balcioglu
- Department of Cardiovascular Surgery, Faculty of Medicine, Near East University, Nicosia, Cyprus
- Department of Medical Genetics, Faculty of Medicine, Near East University, Nicosia, Cyprus
| | - Mahmut Cerkez Ergoren
- Department of Cardiovascular Surgery, Faculty of Medicine, Near East University, Nicosia, Cyprus
- Department of Medical Genetics, Faculty of Medicine, Near East University, Nicosia, Cyprus
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Ragnoli B, Da Re B, Galantino A, Kette S, Salotti A, Malerba M. Interrelationship between COVID-19 and Coagulopathy: Pathophysiological and Clinical Evidence. Int J Mol Sci 2023; 24:ijms24108945. [PMID: 37240292 DOI: 10.3390/ijms24108945] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Revised: 05/14/2023] [Accepted: 05/16/2023] [Indexed: 05/28/2023] Open
Abstract
Since the first description of COVID-19 infection, among clinical manifestations of the disease, including fever, dyspnea, cough, and fatigue, it was observed a high incidence of thromboembolic events potentially evolving towards acute respiratory distress syndrome (ARDS) and COVID-19-associated-coagulopathy (CAC). The hypercoagulation state is based on an interaction between thrombosis and inflammation. The so-called CAC represents a key aspect in the genesis of organ damage from SARS-CoV-2. The prothrombotic status of COVID-19 can be explained by the increase in coagulation levels of D-dimer, lymphocytes, fibrinogen, interleukin 6 (IL-6), and prothrombin time. Several mechanisms have been hypothesized to explain this hypercoagulable process such as inflammatory cytokine storm, platelet activation, endothelial dysfunction, and stasis for a long time. The purpose of this narrative review is to provide an overview of the current knowledge on the pathogenic mechanisms of coagulopathy that may characterize COVID-19 infection and inform on new areas of research. New vascular therapeutic strategies are also reviewed.
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Affiliation(s)
| | - Beatrice Da Re
- Respiratory Unit, Sant'Andrea Hospital, 13100 Vercelli, Italy
| | | | - Stefano Kette
- Respiratory Unit, Sant'Andrea Hospital, 13100 Vercelli, Italy
| | - Andrea Salotti
- Respiratory Unit, Sant'Andrea Hospital, 13100 Vercelli, Italy
| | - Mario Malerba
- Respiratory Unit, Sant'Andrea Hospital, 13100 Vercelli, Italy
- Department of Traslational Medicine, University of Eastern Piedmont (UPO), 28100 Novara, Italy
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Fiorentino G, Benincasa G, Coppola A, Franzese M, Annunziata A, Affinito O, Viglietti M, Napoli C. Targeted genetic analysis unveils novel associations between ACE I/D and APO T158C polymorphisms with D-dimer levels in severe COVID-19 patients with pulmonary embolism. J Thromb Thrombolysis 2023; 55:51-59. [PMID: 36371754 PMCID: PMC9660132 DOI: 10.1007/s11239-022-02728-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/25/2022] [Indexed: 11/14/2022]
Abstract
Only a percentage of COVID-19 patients develop thrombotic complications. We hypothesized that genetic profiles may explain part of the inter-individual differences. Our goal was to evaluate the genotypic distribution of targeted DNA polymorphisms in COVID-19 patients complicated (PE+) or not (PE-) by pulmonary embolism. We designed a retrospective observational study enrolling N = 94 consecutive patients suffering severe COVID-19 with pulmonary embolism (PE+, N = 47) or not (PE-, N = 47) during hospitalization. A panel of N = 13 prothrombotic DNA polymorphisms (FV R506Q and H1299R, FII G20210A, MTHFR C677T and A1298C, CBS 844ins68, PAI-1 4G/5G, GPIIIa HPA-1 a/b, ACE I/D, AGT T9543C, ATR-1 A1166C, FGB - 455G > A, FXIII103G > T) and N = 2 lipid metabolism-related DNA polymorphisms (APOE T 112C and T158C) were investigated using Reverse Dot Blot technique. Then, we investigated possible associations between genotypic subclasses and demographic, clinical, and laboratory parameters including age, obesity, smoking, pro-inflammatory cytokines, drug therapy, and biomarkers of thrombotic risk such as D-dimer (DD). We found that 58.7% of PE+ had homozygous mutant D/D genotype at ACE I/D locus vs. PE- (40.4%) and 87% of PE+ had homozygous mutant C/C genotype at APOE T158C locus vs. PE- (68.1%). In PE+ group, DD levels were significantly higher in D/D and I/D genotypes at ACE I/D locus (P = 0.00066 and P = 0.00023, respectively) and in C/C and T/C genotypes at APOE T158C locus (P = 1.6e-06 and P = 0.0012, respectively) than PE- group. For the first time, we showed significant associations between higher DD levels and ACE I/D and APOE T158C polymorphisms in PE+ vs. PE- patients suggesting potential useful biomarkers of poor clinical outcome.
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Affiliation(s)
| | - Giuditta Benincasa
- Department of Advanced Medical and Surgical Sciences (DAMSS), University of Campania "Luigi Vanvitelli", Naples, Italy.
| | - Antonietta Coppola
- Department of Intensive Care, A.O.R.N. Ospedali dei Colli, Naples, Italy
| | | | - Anna Annunziata
- Department of Intensive Care, A.O.R.N. Ospedali dei Colli, Naples, Italy
| | | | - Mario Viglietti
- Department of Advanced Medical and Surgical Sciences (DAMSS), University of Campania “Luigi Vanvitelli”, Naples, Italy
| | - Claudio Napoli
- Department of Advanced Medical and Surgical Sciences (DAMSS), University of Campania “Luigi Vanvitelli”, Naples, Italy
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11
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Association investigations between ACE1 and ACE2 polymorphisms and severity of COVID-19 disease. Mol Genet Genomics 2023; 298:27-36. [PMID: 36255490 PMCID: PMC9579601 DOI: 10.1007/s00438-022-01953-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2022] [Accepted: 09/03/2022] [Indexed: 01/11/2023]
Abstract
Due to the unique affinity of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) to the angiotensin-converting enzyme 2 (ACE2) receptor in patients, the foremost recent evidence indicated that ACE1 and ACE2 polymorphisms could affect the susceptibility of individuals to SARS-CoV-2 infection and also the disease outcome. Here, we aimed to assess the possible association between two polymorphisms and the severity of disease in patients. In the present study, 146 patients with COVID-19 who were admitted to the Mazandaran University of Medical Sciences hospitals between March 2020 and July 2020 were enrolled in this case-control study. The patients were divided into four groups based on clinical symptoms and severity of the diseases (mild, moderate, severe, and critical). After DNA extraction, the ACE gene I/D polymorphism (rs4646994) and ACE2 gene polymorphism (rs2285666) were genotyped using Gap-PCR and PCR-RFLP techniques, respectively. Then, five samples from each obtained genotype were confirmed by Sanger sequencing technique. Data were analyzed with SAS software version 9.1 using appropriate statistical procedures. The ACE gene I/D polymorphism (rs4646994) genotypes were classified into three types: I/I, I/D, and D/D. Our finding indicated that the prevalence of ACE1 D/D genotype was significantly higher in severe and critical COVID-19 patients (P = 0.0016). Additionally, the analysis revealed a remarkable association between rs4646994 SNP and the HB and ESRI levels in patients (P < 0.05). Although the ACE2 rs2285666 SNP was not related to the severity of disease, this variant was significantly associated with ALT, ESRI, and P. These results provide preliminary evidence of a genetic association between the ACE-D/D genotype and the D allele of ACE1 genotype and the disease severity. Therefore, our findings might be useful for identifying the susceptible population groups for COVID-19 therapy.
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SARS-CoV-2 infection in the context of Kawasaki disease and multisystem inflammatory syndrome in children. Med Microbiol Immunol 2023; 212:3-12. [PMID: 36396785 PMCID: PMC9672612 DOI: 10.1007/s00430-022-00756-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2022] [Accepted: 11/02/2022] [Indexed: 11/18/2022]
Abstract
Recent studies have noted an increasing number of Kawasaki-like cases in the pediatric population following severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. In the literature, the condition is described as multiple inflammatory syndrome in children (MIS-C) or pediatric inflammatory syndrome (PIMS). A similar clinical course of Kawasaki disease (KD) and MIS-C causes difficulties in distinguishing between both conditions. However, the differential diagnosis is crucial since patients with MIS-C can present severe symptoms (myocardial dysfunction, fever, mucocutaneous symptoms) and require more extensive monitoring during treatment than children diagnosed with KD. Along with assessing epidemiological and genetic factors, it is imperative to estimate the risk of developing MIS-C in KD patients with confirmed SARS-CoV-2 infection. Genetic predispositions, such as the ITPKC gene polymorphism in KD, ACE deletion (D) polymorphism in SARS-CoV-2, and inborn errors of immunity (IEIs) in MIS-C affect the regulation of immune system complex clearances and cellular adaptations. The virus has a tropism for both vascular and respiratory cells, which further causes additional symptoms necessitating standard therapy with antithrombotic treatment. The diagnostic criteria for KD, MIS-C, and SARS-CoV-2 help differentiate each condition and optimize treatment strategies. Unfortunately, long-term outcomes in KD patients who develop MIS-C due to SARS-CoV-2 infection have been inadequately documented due to the timing of the pandemic, further displaying the need for longitudinal studies in these patients. This review underlines the differences in diagnosis and treatment of KD and MIS-C. Overall, children with KD may develop MIS-C in the setting of SARS-CoV-2 infection, but further research is needed to outline specific etiologies, prognostic factors, and diagnoses.
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Rezaei M, Mohammadpour H, Eftekhari M, Pourabdollah M, Nasr Azadani F, Tabarsi P, Marjani M, Ziai SA. The role of angiotensin I converting enzyme insertion/deletion polymorphism in the severity and outcomes of COVID-19 patients. Front Genet 2022; 13:1035796. [DOI: 10.3389/fgene.2022.1035796] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2022] [Accepted: 11/07/2022] [Indexed: 12/04/2022] Open
Abstract
The pandemic of coronavirus disease in 2019 has led to a global crisis. COVID-19 shows distinct clinical manifestations of the severity of symptoms. Numerous patients with no associated risk factors demonstrate acute respiratory distress syndrome (ARDS). The role of genetic factors in determining the severity and outcome of the disease remains unresolved. The purpose of this study was to see if a correlation exists between Angiotensin I Converting Enzyme (ACE) insertion/deletion (I/D) polymorphism and the severity of COVID-19 patients’ symptoms. 120 COVID-19 patients admitted to Masih Daneshvari Hospital in Tehran with their consent to participate entered the study. Based on the World Health Organization classification, patients were divided into moderate and severe groups, which were primarily affected by O2 saturation levels. The effects of the patients’ ACE insertion/deletion polymorphism, background disease, Angiotensin receptor blocker (ARB) drug consumption, and demographic parameters on the severity risk were calculated statistically. The ACE D allele was associated with an increased risk of disease severity (OR = 6.766, p = 0.012), but had no effect on mortality.
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Khalilzadeh F, Sakhaee F, Sotoodehnejadnematalahi F, Zamani MS, Ahmadi I, Anvari E, Fateh A. Angiotensin-converting enzyme 2 rs2285666 polymorphism and clinical parameters as the determinants of COVID-19 severity in Iranian population. Int J Immunogenet 2022; 49:325-332. [PMID: 36029284 PMCID: PMC9539076 DOI: 10.1111/iji.12598] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2022] [Revised: 08/02/2022] [Accepted: 08/10/2022] [Indexed: 12/24/2022]
Abstract
Host genetic factors may be correlated with the severity of coronavirus disease 2019 (COVID-19). Angiotensin-converting enzyme 2 (ACE2) plays a vital role in viral cell entrance. The current study aimed to evaluate the association of ACE2 rs2285666 polymorphism and clinical parameters with COVID-19 mortality. The ACE2 rs2285666 polymorphism was genotyped using the polymerase chain reaction-restriction fragment length polymorphism in 556 recovered and 522 dead patients. In this study, the frequency of ACE2 rs2285666 CC was significantly higher than TT genotype in dead patients. The multivariate logistic regression analysis results showed that the higher levels of alanine aminotransferase, alkaline phosphatase, creatinine, erythrocyte sedimentation rate, and C-reactive protein and the low levels of uric acid, cholesterol, low density lipoprotein, 25-hydroxyvitamin D, real-time PCR Ct values, and ACE2 rs2285666 CC genotype were associated with increased mortality rates after COVID-19. In conclusion, our findings demonstrated a possible link between COVID-19 mortality, clinical parameters, and ACE2 rs2285666 CC. Further research is required to confirm these results.
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Affiliation(s)
- Fereshteh Khalilzadeh
- Department of Biology, Science and Research Branch, Islamic Azad University, Tehran, Iran
| | - Fatemeh Sakhaee
- Department of Mycobacteriology and Pulmonary Research, Pasteur Institute of Iran, Tehran, Iran
| | | | | | - Iraj Ahmadi
- Department of Physiology, School of Medicine, Ilam University of Medical Science, Ilam, Iran
| | - Enayat Anvari
- Department of Physiology, School of Medicine, Ilam University of Medical Science, Ilam, Iran
| | - Abolfazl Fateh
- Department of Mycobacteriology and Pulmonary Research, Pasteur Institute of Iran, Tehran, Iran.,Microbiology Research Center (MRC), Pasteur Institute of Iran, Tehran, Iran
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Konkol SB, Ramani C, Martin DN, Harnish-Cruz CK, Mietla KM, Sessums RF, Widere JC, Kadl A. Differences in lung function between major race/ethnicity groups following hospitalization with COVID-19. Respir Med 2022; 201:106939. [PMID: 36029696 PMCID: PMC9357276 DOI: 10.1016/j.rmed.2022.106939] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/10/2022] [Revised: 07/19/2022] [Accepted: 07/21/2022] [Indexed: 12/03/2022]
Abstract
Background Ethnic minorities have higher rates of infection, hospitalization, and death from COVID-19 compared to White Americans. Research question Is race/ethnicity an independent predictor of lung dysfunction following hospitalization with COVID-19? Study design and Methods: Patients hospitalized at the University of Virginia Medical Center with COVID-19 underwent a questionnaire within 30 days following discharge. Those who had persistent respiratory symptoms were invited to complete spirometry, lung volumes, and diffusion capacity of carbon monoxide. 128 completed pulmonary function testing at 6 months. Results Impairments in lung function were present in spirometry, lung volumes, and diffusion capacity of carbon monoxide at 6 months. The most prevalent impairments were noted in FVC (24.4%), FEV1 (20.5%), TLC (23.3%), and DLCO (20.8%). When compared between race/ethnicity groups three lung function parameters demonstrated statistically significant difference, including FEV1/FVC (p = 0.021), RV/TLC (p = 0.006) and DLCO % predicted (p = 0.002). The average difference between Hispanic and non-Hispanic Black patients with respect to DLCO % predicted was 13.09 (p = 0.01) and the average difference between non-Hispanic White and non-Hispanic Black patients was 9.46 (p = 0.04). Differences persisted when controlling for age, BMI, smoking status, history of chronic lung disease, ICU admission, treatment with corticosteroids, and socioeconomic status. Interpretation Long-term impairments in lung function following COVID-19 are common, occurring in roughly 22% of patients and across all three major domains of lung function. Non-Hispanic Black race/ethnicity was associated with a statistically significant lower DLCO % predicted when compared to non-Hispanic White and Hispanic patients.
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Affiliation(s)
- Samuel B Konkol
- University of Virginia Health Systems, 1215 Lee Street, Charlottesville, VA, 22903, USA.
| | - Chintan Ramani
- MedStar Georgetown University Hospital, 3800 Reservoir Rd. NW, Washington, DC, 20007, USA.
| | - David N Martin
- University of Virginia Health Systems, 1215 Lee Street, Charlottesville, VA, 22903, USA.
| | - Carissa K Harnish-Cruz
- University of Virginia Health Systems, 1215 Lee Street, Charlottesville, VA, 22903, USA.
| | - Kelsie M Mietla
- University of Virginia Health Systems, 1215 Lee Street, Charlottesville, VA, 22903, USA.
| | - Ryan F Sessums
- University of Virginia Health Systems, 1215 Lee Street, Charlottesville, VA, 22903, USA.
| | - John C Widere
- University of Virginia Health Systems, 1215 Lee Street, Charlottesville, VA, 22903, USA.
| | - Alexandra Kadl
- University of Virginia Health Systems, 1215 Lee Street, Charlottesville, VA, 22903, USA.
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Angulo-Aguado M, Corredor-Orlandelli D, Carrillo-Martínez JC, Gonzalez-Cornejo M, Pineda-Mateus E, Rojas C, Triana-Fonseca P, Contreras Bravo NC, Morel A, Parra Abaunza K, Restrepo CM, Fonseca-Mendoza DJ, Ortega-Recalde O. Association Between the LZTFL1 rs11385942 Polymorphism and COVID-19 Severity in Colombian Population. Front Med (Lausanne) 2022; 9:910098. [PMID: 35795626 PMCID: PMC9251207 DOI: 10.3389/fmed.2022.910098] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Accepted: 05/26/2022] [Indexed: 01/08/2023] Open
Abstract
Genetic and non-genetic factors are responsible for the high interindividual variability in the response to SARS-CoV-2. Although numerous genetic polymorphisms have been identified as risk factors for severe COVID-19, these remain understudied in Latin-American populations. This study evaluated the association of non-genetic factors and three polymorphisms: ACE rs4646994, ACE2 rs2285666, and LZTFL1 rs11385942, with COVID severity and long-term symptoms by using a case-control design. The control group was composed of asymptomatic/mild cases (n = 61) recruited from a private laboratory, while the case group was composed of severe/critical patients (n = 63) hospitalized in the Hospital Universitario Mayor-Méderi, both institutions located in Bogotá, Colombia. Clinical follow up and exhaustive revision of medical records allowed us to assess non-genetic factors. Genotypification of the polymorphism of interest was performed by amplicon size analysis and Sanger sequencing. In agreement with previous reports, we found a statistically significant association between age, male sex, and comorbidities, such as hypertension and type 2 diabetes mellitus (T2DM), and worst outcomes. We identified the polymorphism LZTFL1 rs11385942 as an important risk factor for hospitalization (p < 0.01; OR = 5.73; 95% CI = 1.2–26.5, under the allelic test). Furthermore, long-term symptoms were common among the studied population and associated with disease severity. No association between the polymorphisms examined and long-term symptoms was found. Comparison of allelic frequencies with other populations revealed significant differences for the three polymorphisms investigated. Finally, we used the statistically significant genetic and non-genetic variables to develop a predictive logistic regression model, which was implemented in a Shiny web application. Model discrimination was assessed using the area under the receiver operating characteristic curve (AUC = 0.86; 95% confidence interval 0.79–0.93). These results suggest that LZTFL1 rs11385942 may be a potential biomarker for COVID-19 severity in addition to conventional non-genetic risk factors. A better understanding of the impact of these genetic risk factors may be useful to prioritize high-risk individuals and decrease the morbimortality caused by SARS-CoV2 and future pandemics.
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Affiliation(s)
- Mariana Angulo-Aguado
- Center for Research in Genetics and Genomics – CIGGUR, GENIUROS Research Group, School of Medicine and Health Sciences, Universidad Del Rosario, Bogotá, Colombia
| | - David Corredor-Orlandelli
- Center for Research in Genetics and Genomics – CIGGUR, GENIUROS Research Group, School of Medicine and Health Sciences, Universidad Del Rosario, Bogotá, Colombia
| | - Juan Camilo Carrillo-Martínez
- Center for Research in Genetics and Genomics – CIGGUR, GENIUROS Research Group, School of Medicine and Health Sciences, Universidad Del Rosario, Bogotá, Colombia
| | - Mónica Gonzalez-Cornejo
- Center for Research in Genetics and Genomics – CIGGUR, GENIUROS Research Group, School of Medicine and Health Sciences, Universidad Del Rosario, Bogotá, Colombia
| | - Eliana Pineda-Mateus
- Center for Research in Genetics and Genomics – CIGGUR, GENIUROS Research Group, School of Medicine and Health Sciences, Universidad Del Rosario, Bogotá, Colombia
| | - Carolina Rojas
- Center for Research in Genetics and Genomics – CIGGUR, GENIUROS Research Group, School of Medicine and Health Sciences, Universidad Del Rosario, Bogotá, Colombia
| | - Paula Triana-Fonseca
- Department of Molecular Diagnosis, Genética Molecular de Colombia SAS, Bogotá, Colombia
| | - Nora Constanza Contreras Bravo
- Center for Research in Genetics and Genomics – CIGGUR, GENIUROS Research Group, School of Medicine and Health Sciences, Universidad Del Rosario, Bogotá, Colombia
| | - Adrien Morel
- Center for Research in Genetics and Genomics – CIGGUR, GENIUROS Research Group, School of Medicine and Health Sciences, Universidad Del Rosario, Bogotá, Colombia
| | | | - Carlos M. Restrepo
- Center for Research in Genetics and Genomics – CIGGUR, GENIUROS Research Group, School of Medicine and Health Sciences, Universidad Del Rosario, Bogotá, Colombia
| | - Dora Janeth Fonseca-Mendoza
- Center for Research in Genetics and Genomics – CIGGUR, GENIUROS Research Group, School of Medicine and Health Sciences, Universidad Del Rosario, Bogotá, Colombia
- Dora Janeth Fonseca-Mendoza
| | - Oscar Ortega-Recalde
- Center for Research in Genetics and Genomics – CIGGUR, GENIUROS Research Group, School of Medicine and Health Sciences, Universidad Del Rosario, Bogotá, Colombia
- *Correspondence: Oscar Ortega-Recalde
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Considerations for the future: current and future treatment paradigms with mineralocorticoid receptor antagonists—unmet needs and underserved patient cohorts. Kidney Int Suppl (2011) 2022; 12:69-75. [DOI: 10.1016/j.kisu.2021.11.008] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2021] [Revised: 10/28/2021] [Accepted: 11/08/2021] [Indexed: 12/20/2022] Open
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Martínez-Gómez LE, Herrera-López B, Martinez-Armenta C, Ortega-Peña S, Camacho-Rea MDC, Suarez-Ahedo C, Vázquez-Cárdenas P, Vargas-Alarcón G, Rojas-Velasco G, Fragoso JM, Vidal-Vázquez P, Ramírez-Hinojosa JP, Rodríguez-Sánchez Y, Barrón-Díaz D, Moreno ML, Martínez-Ruiz FDJ, Zayago-Angeles DM, Mata-Miranda MM, Vázquez-Zapién GJ, Martínez-Cuazitl A, Barajas-Galicia E, Bustamante-Silva L, Zazueta-Arroyo D, Rodríguez-Pérez JM, Hernández-González O, Coronado-Zarco R, Lucas-Tenorio V, Franco-Cendejas R, López-Jácome LE, Vázquez-Juárez RC, Magaña JJ, Cruz-Ramos M, Granados J, Hernández-Doño S, Delgado-Saldivar D, Ramos-Tavera L, Coronado-Zarco I, Guajardo-Salinas G, Muñoz-Valle JF, Pineda C, Martínez-Nava GA, López-Reyes A. ACE and ACE2 Gene Variants Are Associated With Severe Outcomes of COVID-19 in Men. Front Immunol 2022; 13:812940. [PMID: 35250987 PMCID: PMC8892378 DOI: 10.3389/fimmu.2022.812940] [Citation(s) in RCA: 22] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2021] [Accepted: 01/25/2022] [Indexed: 01/08/2023] Open
Abstract
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is responsible for the current coronavirus disease 2019 (COVID-19) pandemic, affecting more than 219 countries and causing the death of more than 5 million people worldwide. The genetic background represents a factor that predisposes the way the host responds to SARS-CoV-2 infection. In this sense, genetic variants of ACE and ACE2 could explain the observed interindividual variability to COVID-19 outcomes. In order to improve the understanding of how genetic variants of ACE and ACE2 are involved in the severity of COVID-19, we included a total of 481 individuals who showed clinical manifestations of COVID-19 and were diagnosed by reverse transcription PCR (RT-PCR). Genomic DNA was extracted from peripheral blood and saliva samples. ACE insertion/deletion polymorphism was evaluated by the high-resolution melting method; ACE single-nucleotide polymorphism (SNP) (rs4344) and ACE2 SNPs (rs2285666 and rs2074192) were genotyped using TaqMan probes. We assessed the association of ACE and ACE2 polymorphisms with disease severity using logistic regression analysis adjusted by age, sex, hypertension, type 2 diabetes, and obesity. The severity of the illness in our study population was divided as 31% mild, 26% severe, and 43% critical illness; additionally, 18% of individuals died, of whom 54% were male. Our results showed in the codominant model a contribution of ACE2 gene rs2285666 T/T genotype to critical outcome [odds ratio (OR) = 1.83; 95%CI = 1.01–3.29; p = 0.04] and to require oxygen supplementation (OR = 1.76; 95%CI = 1.01–3.04; p = 0.04), in addition to a strong association of the T allele of this variant to develop critical illness in male individuals (OR = 1.81; 95%CI = 1.10–2.98; p = 0.02). We suggest that the T allele of rs2285666 represents a risk factor for severe and critical outcomes of COVID-19, especially for men, regardless of age, hypertension, obesity, and type 2 diabetes.
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Affiliation(s)
- Laura E. Martínez-Gómez
- Laboratorio de Gerociencias, Dirección General, Medicina de Rehabilitación, Laboratorio de Infectología, Departamento de Reconstrucción Articular, Laboratorio de Medicina Genómica, Laboratorio Facilitador, Instituto Nacional de Rehabilitación Luis Guillermo Ibarra Ibarra, Secretaría de Salud, Mexico City, Mexico
| | - Brígida Herrera-López
- Laboratorio de Gerociencias, Dirección General, Medicina de Rehabilitación, Laboratorio de Infectología, Departamento de Reconstrucción Articular, Laboratorio de Medicina Genómica, Laboratorio Facilitador, Instituto Nacional de Rehabilitación Luis Guillermo Ibarra Ibarra, Secretaría de Salud, Mexico City, Mexico
| | - Carlos Martinez-Armenta
- Postgrado en Biología Experimental, Dirección de Ciencias Biológicas y de la Salud (DCBS), Universidad Autónoma Metropolitana Iztapalapa, Mexico City, Mexico
| | - Silvestre Ortega-Peña
- Laboratorio de Gerociencias, Dirección General, Medicina de Rehabilitación, Laboratorio de Infectología, Departamento de Reconstrucción Articular, Laboratorio de Medicina Genómica, Laboratorio Facilitador, Instituto Nacional de Rehabilitación Luis Guillermo Ibarra Ibarra, Secretaría de Salud, Mexico City, Mexico
| | - María del Carmen Camacho-Rea
- Departamento de Nutrición Animal, Departamento de Inmunogenética, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Secretaría de Salud, Mexico City, Mexico
| | - Carlos Suarez-Ahedo
- Laboratorio de Gerociencias, Dirección General, Medicina de Rehabilitación, Laboratorio de Infectología, Departamento de Reconstrucción Articular, Laboratorio de Medicina Genómica, Laboratorio Facilitador, Instituto Nacional de Rehabilitación Luis Guillermo Ibarra Ibarra, Secretaría de Salud, Mexico City, Mexico
| | - Paola Vázquez-Cárdenas
- Centro de Innovación Médica Aplicada, Subdirección de Epidemiología e Infectología, Hospital General Dr. Manuel Gea González, Mexico City, Mexico
| | - Gilberto Vargas-Alarcón
- Departamento de Biología Molecular y Unidad de Cuidados Intensivos, Instituto Nacional de Cardiología Ignacio Chavez, Mexico City, Mexico
| | - Gustavo Rojas-Velasco
- Departamento de Biología Molecular y Unidad de Cuidados Intensivos, Instituto Nacional de Cardiología Ignacio Chavez, Mexico City, Mexico
| | - José Manuel Fragoso
- Departamento de Biología Molecular y Unidad de Cuidados Intensivos, Instituto Nacional de Cardiología Ignacio Chavez, Mexico City, Mexico
| | - Patricia Vidal-Vázquez
- Centro de Innovación Médica Aplicada, Subdirección de Epidemiología e Infectología, Hospital General Dr. Manuel Gea González, Mexico City, Mexico
| | - Juan P. Ramírez-Hinojosa
- Centro de Innovación Médica Aplicada, Subdirección de Epidemiología e Infectología, Hospital General Dr. Manuel Gea González, Mexico City, Mexico
| | - Yunuen Rodríguez-Sánchez
- Centro de Innovación Médica Aplicada, Subdirección de Epidemiología e Infectología, Hospital General Dr. Manuel Gea González, Mexico City, Mexico
| | - David Barrón-Díaz
- Centro de Innovación Médica Aplicada, Subdirección de Epidemiología e Infectología, Hospital General Dr. Manuel Gea González, Mexico City, Mexico
| | - Mariana L. Moreno
- Nuevo Hospital General Delegación Regional Sur de la Ciudad de México ISSSTE, Mexico City, Mexico
| | | | - Dulce M. Zayago-Angeles
- Nuevo Hospital General Delegación Regional Sur de la Ciudad de México ISSSTE, Mexico City, Mexico
| | - Mónica Maribel Mata-Miranda
- Laboratorio de Biología Celular y Tisular, Laboratorio de Embriología, Escuela Militar de Medicina, Universidad del Ejército y Fuerza Aérea, Ciudad de México, Mexico
| | - Gustavo Jesús Vázquez-Zapién
- Laboratorio de Biología Celular y Tisular, Laboratorio de Embriología, Escuela Militar de Medicina, Universidad del Ejército y Fuerza Aérea, Ciudad de México, Mexico
| | - Adriana Martínez-Cuazitl
- Laboratorio de Biología Celular y Tisular, Laboratorio de Embriología, Escuela Militar de Medicina, Universidad del Ejército y Fuerza Aérea, Ciudad de México, Mexico
| | - Edith Barajas-Galicia
- Servicio de Cirugía General, Hospital Central Norte Petróleos Mexicanos (PEMEX), Mexico City, Mexico
| | - Ludwing Bustamante-Silva
- Servicio de Cirugía General, Hospital Central Norte Petróleos Mexicanos (PEMEX), Mexico City, Mexico
| | - Diana Zazueta-Arroyo
- Servicio de Cirugía General, Hospital Central Norte Petróleos Mexicanos (PEMEX), Mexico City, Mexico
| | - José Manuel Rodríguez-Pérez
- Departamento de Biología Molecular y Unidad de Cuidados Intensivos, Instituto Nacional de Cardiología Ignacio Chavez, Mexico City, Mexico
| | - Olivia Hernández-González
- Laboratorio de Gerociencias, Dirección General, Medicina de Rehabilitación, Laboratorio de Infectología, Departamento de Reconstrucción Articular, Laboratorio de Medicina Genómica, Laboratorio Facilitador, Instituto Nacional de Rehabilitación Luis Guillermo Ibarra Ibarra, Secretaría de Salud, Mexico City, Mexico
| | - Roberto Coronado-Zarco
- Laboratorio de Gerociencias, Dirección General, Medicina de Rehabilitación, Laboratorio de Infectología, Departamento de Reconstrucción Articular, Laboratorio de Medicina Genómica, Laboratorio Facilitador, Instituto Nacional de Rehabilitación Luis Guillermo Ibarra Ibarra, Secretaría de Salud, Mexico City, Mexico
| | - Vania Lucas-Tenorio
- Laboratorio de Gerociencias, Dirección General, Medicina de Rehabilitación, Laboratorio de Infectología, Departamento de Reconstrucción Articular, Laboratorio de Medicina Genómica, Laboratorio Facilitador, Instituto Nacional de Rehabilitación Luis Guillermo Ibarra Ibarra, Secretaría de Salud, Mexico City, Mexico
| | - Rafael Franco-Cendejas
- Laboratorio de Gerociencias, Dirección General, Medicina de Rehabilitación, Laboratorio de Infectología, Departamento de Reconstrucción Articular, Laboratorio de Medicina Genómica, Laboratorio Facilitador, Instituto Nacional de Rehabilitación Luis Guillermo Ibarra Ibarra, Secretaría de Salud, Mexico City, Mexico
| | - Luis Esau López-Jácome
- Laboratorio de Gerociencias, Dirección General, Medicina de Rehabilitación, Laboratorio de Infectología, Departamento de Reconstrucción Articular, Laboratorio de Medicina Genómica, Laboratorio Facilitador, Instituto Nacional de Rehabilitación Luis Guillermo Ibarra Ibarra, Secretaría de Salud, Mexico City, Mexico
| | - Rocío Carmen Vázquez-Juárez
- Laboratorio de Gerociencias, Dirección General, Medicina de Rehabilitación, Laboratorio de Infectología, Departamento de Reconstrucción Articular, Laboratorio de Medicina Genómica, Laboratorio Facilitador, Instituto Nacional de Rehabilitación Luis Guillermo Ibarra Ibarra, Secretaría de Salud, Mexico City, Mexico
| | - Jonathan J. Magaña
- Laboratorio de Gerociencias, Dirección General, Medicina de Rehabilitación, Laboratorio de Infectología, Departamento de Reconstrucción Articular, Laboratorio de Medicina Genómica, Laboratorio Facilitador, Instituto Nacional de Rehabilitación Luis Guillermo Ibarra Ibarra, Secretaría de Salud, Mexico City, Mexico
| | - Marlid Cruz-Ramos
- Programa de Investigadoras e investigadores por México del Consejo Nacional de Ciencia y Tecnología (CONACYT), Instituto Nacional de Cancerología, Mexico City, Mexico
| | - Julio Granados
- Departamento de Nutrición Animal, Departamento de Inmunogenética, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Secretaría de Salud, Mexico City, Mexico
| | - Susana Hernández-Doño
- Departamento de Nutrición Animal, Departamento de Inmunogenética, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Secretaría de Salud, Mexico City, Mexico
| | - Diego Delgado-Saldivar
- Departamento de Nutrición Animal, Departamento de Inmunogenética, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Secretaría de Salud, Mexico City, Mexico
| | - Luis Ramos-Tavera
- Departamento de Nutrición Animal, Departamento de Inmunogenética, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Secretaría de Salud, Mexico City, Mexico
| | - Irma Coronado-Zarco
- Instituto Nacional de Perinatología Isidro Espinosa de los Reyes, Mexico City, Mexico
| | | | - José Francisco Muñoz-Valle
- Instituto de Investigación en Ciencias Biomédicas, Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Guadalajara, Mexico
| | - Carlos Pineda
- Laboratorio de Gerociencias, Dirección General, Medicina de Rehabilitación, Laboratorio de Infectología, Departamento de Reconstrucción Articular, Laboratorio de Medicina Genómica, Laboratorio Facilitador, Instituto Nacional de Rehabilitación Luis Guillermo Ibarra Ibarra, Secretaría de Salud, Mexico City, Mexico
| | - Gabriela Angélica Martínez-Nava
- Laboratorio de Gerociencias, Dirección General, Medicina de Rehabilitación, Laboratorio de Infectología, Departamento de Reconstrucción Articular, Laboratorio de Medicina Genómica, Laboratorio Facilitador, Instituto Nacional de Rehabilitación Luis Guillermo Ibarra Ibarra, Secretaría de Salud, Mexico City, Mexico
- *Correspondence: Alberto López-Reyes, ; Gabriela Angélica Martínez-Nava,
| | - Alberto López-Reyes
- Laboratorio de Gerociencias, Dirección General, Medicina de Rehabilitación, Laboratorio de Infectología, Departamento de Reconstrucción Articular, Laboratorio de Medicina Genómica, Laboratorio Facilitador, Instituto Nacional de Rehabilitación Luis Guillermo Ibarra Ibarra, Secretaría de Salud, Mexico City, Mexico
- *Correspondence: Alberto López-Reyes, ; Gabriela Angélica Martínez-Nava,
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Baştuğ S, Çavdarlı B, Baştuğ A, Şencan İ, Tunçez E, Çakır EY, Kemirtlek N, Sakar C, Erdem D, Ceylan GG, Turan IÖ, Kazancıoğlu S, Bodur H. Are angiotensin converting enzyme (ACE1/ACE2) gene variants associated with the clinical severity of COVID-19 pneumonia? A single-center cohort study. Anatol J Cardiol 2022; 26:133-140. [PMID: 35190362 PMCID: PMC8878912 DOI: 10.5152/anatoljcardiol.2021.502] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/02/2021] [Indexed: 08/02/2023] Open
Abstract
OBJECTIVE The impact of the coronavirus disease 2019 (COVID-19) pandemic has been unceasingly ongoing worldwide. Recent bioinformatics analysis and epidemiologic studies have highlighted that the functional polymorphisms on the angiotensin converting enzyme (ACE) gene may have an impact on the clinical progress of COVID-19. In this study, we aimed to determine the impact of the ACE1 gene I/D polymorphism and ACE2 peptidase-2 domain variants on disease severity. METHODS Hundred patients with confirmed COVID-19 related pneumonia [50 patients with severe disease in intensive care unit (ICU) and 50 patients not in ICU] were compared on the basis of genetic and clinical characteristics. Genomic DNA was purified from peripheral blood lymphocytes with an automated QIA symphony DSP DNA Mini-Kit. The Sanger sequencing analysis was performed. The frequencies of ACE1 gene polymorphism and ACE2 PD variants were compared in patients hospitalized in ICU and those not in ICU. The Statistical Package for Social Sciences version 22.0 was used for statistical analysis. RESULTS The sequencing analysis of the ACE2 gene exon 1 and 2 revealed none of the polymorphisms investigated or any other variants in the present cohort. The frequencies of the ACE1 ID, DD, and II genotypes were 51%, 31%, and 18%, respectively. The frequency of the D allele was similar between the ICU and non-ICU groups (50.4% versus 49.6%). Older age and the presence of advanced stage radiologic abnormalities on admission were detected as independent predictors of ICU requirement. CONCLUSION No effect of any ACE1 gene polymorphism on predicting ICU requirement was detected. To the best of our knowledge, this is the first study investigating the impact of ACE gene polymorphisms on clinical severity of COVID-19 in a Turkish cohort.
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Affiliation(s)
- Serdal Baştuğ
- Department of Cardiology, Ankara Yıldırım Beyazıt University, Ankara City Hospital; Ankara-Turkey
| | | | - Aliye Baştuğ
- Department of Infectious Disease and Clinical Microbiology, Health Science University Turkey, Ankara City Hospital; Ankara-Turkey
| | - İrfan Şencan
- Department of Infectious Disease and Clinical Microbiology, Health Science University Turkey, Ankara Dışkapı Yıldırım Beyazıt Hospital; Ankara-Turkey
| | - Ebru Tunçez
- Department of Medical Genetics, Ankara City Hospital; Ankara-Turkey
| | - Esra Yakışık Çakır
- Department of Anesthesiology and Reanimation, Critical Care Medicine, Ankara City Hospital; Ankara-Turkey
| | - Nizamettin Kemirtlek
- Department of Infectious Disease and Clinical Microbiology, Ankara City Hospital; Ankara-Turkey
| | - Cihad Sakar
- Department of Infectious Disease and Clinical Microbiology, Ankara Dışkapı Yıldırım Beyazıt Hospital; Ankara-Turkey
| | - Deniz Erdem
- Department of Anesthesiology and Reanimation, Critical Care Medicine, Health Science University Turkey, Ankara City Hospital; Ankara-Turkey
| | - Gülay Güleç Ceylan
- Department of Medical Genetics, Ankara Yıldırım Beyazıt University, Ankara City Hospital; Ankara-Turkey
| | - Işıl Özkoçak Turan
- Department of Anesthesiology and Reanimation, Critical Care Medicine, Health Science University Turkey, Ankara City Hospital; Ankara-Turkey
| | - Sümeyye Kazancıoğlu
- Department of Infectious Disease and Clinical Microbiology, Ankara City Hospital; Ankara-Turkey
| | - Hürrem Bodur
- Department of Infectious Disease and Clinical Microbiology, Health Science University Turkey, Ankara City Hospital; Ankara-Turkey
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20
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Mahmood ZS, Fadhil HY, Abdul Hussein TA, Ad'hiah AH. Severity of coronavirus disease 19: Profile of inflammatory markers and ACE (rs4646994) and ACE2 (rs2285666) gene polymorphisms in Iraqi patients. Meta Gene 2022; 31:101014. [PMID: 35036327 PMCID: PMC8744396 DOI: 10.1016/j.mgene.2022.101014] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2021] [Revised: 12/07/2021] [Accepted: 01/06/2022] [Indexed: 12/27/2022] Open
Abstract
Susceptibility to coronavirus disease 2019 (COVID-19) and disease severity has recently been associated with inflammatory markers and genetic polymorphisms of ACE (angiotensin-converting enzyme) and ACE2 genes, but the evidence has been inconclusive. This case-control study (99 COVID-19 patients and 96 controls) sought to assess the significance of age, C-reactive protein (CRP), neutrophil-to-lymphocyte ratio (NLR) and SARS-CoV-2 RT-PCR cycle threshold (Ct) in severity of COVID-19. Besides, two variants of ACE and ACE2 genes (rs4646994 and rs2285666, respectively) were analyzed to determine their role in COVID-19 susceptibility and/or disease severity. Results revealed that age, CRP and NLR were significantly elevated in severe cases compared to moderate cases, while RT-PCR Ct value was significantly decreased. Allele and genotypes of both variants were not associated with COVID-19 risk, with the exception of rs2285666 A allele. It showed a significantly higher frequency in female patients than in female controls (probability = 0.041). In conclusion, the study indicated the role of age, CRP, NLR and SARS-CoV-2 RT-PCR Ct in susceptibility to COVID-19 severity. However, analysis of the ACE and ACE2 gene variants (rs4646994 and rs2285666, respectively) showed that the two variants were not associated with the risk of developing COVID-19.
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Affiliation(s)
- Zainab S Mahmood
- Department of Biology, College of Science, University of Baghdad, Baghdad, Iraq
| | - Hula Y Fadhil
- Department of Biology, College of Science, University of Baghdad, Baghdad, Iraq
| | | | - Ali H Ad'hiah
- Tropical-Biological Research Unit, College of Science, University of Baghdad, Baghdad, Iraq
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21
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El-Arif G, Farhat A, Khazaal S, Annweiler C, Kovacic H, Wu Y, Cao Z, Fajloun Z, Khattar ZA, Sabatier JM. The Renin-Angiotensin System: A Key Role in SARS-CoV-2-Induced COVID-19. Molecules 2021; 26:6945. [PMID: 34834033 PMCID: PMC8622307 DOI: 10.3390/molecules26226945] [Citation(s) in RCA: 33] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2021] [Revised: 11/13/2021] [Accepted: 11/15/2021] [Indexed: 01/08/2023] Open
Abstract
The novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the causative agent of coronavirus disease 2019 (COVID-19), was first identified in Eastern Asia (Wuhan, China) in December 2019. The virus then spread to Europe and across all continents where it has led to higher mortality and morbidity, and was declared as a pandemic by the World Health Organization (WHO) in March 2020. Recently, different vaccines have been produced and seem to be more or less effective in protecting from COVID-19. The renin-angiotensin system (RAS), an essential enzymatic cascade involved in maintaining blood pressure and electrolyte balance, is involved in the pathogenicity of COVID-19, since the angiotensin-converting enzyme II (ACE2) acts as the cellular receptor for SARS-CoV-2 in many human tissues and organs. In fact, the viral entrance promotes a downregulation of ACE2 followed by RAS balance dysregulation and an overactivation of the angiotensin II (Ang II)-angiotensin II type I receptor (AT1R) axis, which is characterized by a strong vasoconstriction and the induction of the profibrotic, proapoptotic and proinflammatory signalizations in the lungs and other organs. This mechanism features a massive cytokine storm, hypercoagulation, an acute respiratory distress syndrome (ARDS) and subsequent multiple organ damage. While all individuals are vulnerable to SARS-CoV-2, the disease outcome and severity differ among people and countries and depend on a dual interaction between the virus and the affected host. Many studies have already pointed out the importance of host genetic polymorphisms (especially in the RAS) as well as other related factors such age, gender, lifestyle and habits and underlying pathologies or comorbidities (diabetes and cardiovascular diseases) that could render individuals at higher risk of infection and pathogenicity. In this review, we explore the correlation between all these risk factors as well as how and why they could account for severe post-COVID-19 complications.
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Affiliation(s)
- George El-Arif
- Department of Biology, Faculty of Sciences 2, Campus Fanar, Lebanese University, Jdeidet El-Matn 1202, Lebanon; (G.E.-A.); (A.F.)
| | - Antonella Farhat
- Department of Biology, Faculty of Sciences 2, Campus Fanar, Lebanese University, Jdeidet El-Matn 1202, Lebanon; (G.E.-A.); (A.F.)
| | - Shaymaa Khazaal
- Department of Biology, Faculty of Sciences 3, Campus Michel Slayman Ras Maska, Lebanese University, Tripoli 1352, Lebanon;
| | - Cédric Annweiler
- Research Center on Autonomy and Longevity, Department of Geriatric Medicine and Memory Clinic, University Hospital, Laboratoire de Psychologie des Pays de la Loire, LPPL EA 4638, SFR Confluences, University of Angers, 44312 Angers, France;
| | - Hervé Kovacic
- Institute of NeuroPhysiopathology, Aix-Marseille University, CNRS, INP, 13385 Marseille, France;
| | - Yingliang Wu
- Modern Virology Research Center, State Key Laboratory of Virology, College of Life Sciences, Wuhan University, Wuhan 430072, China; (Y.W.); (Z.C.)
| | - Zhijian Cao
- Modern Virology Research Center, State Key Laboratory of Virology, College of Life Sciences, Wuhan University, Wuhan 430072, China; (Y.W.); (Z.C.)
| | - Ziad Fajloun
- Department of Biology, Faculty of Sciences 3, Campus Michel Slayman Ras Maska, Lebanese University, Tripoli 1352, Lebanon;
- Azm Center for Research in Biotechnology and Its Applications, Laboratory of Applied Biotechnology (LBA3B), EDST, Lebanese University, Tripoli 1300, Lebanon
| | - Ziad Abi Khattar
- Department of Biology, Faculty of Sciences 2, Campus Fanar, Lebanese University, Jdeidet El-Matn 1202, Lebanon; (G.E.-A.); (A.F.)
- Laboratory of Georesources, Geosciences and Environment (L2GE), Microbiology/Tox-Ecotoxicology Team, Faculty of Sciences 2, Lebanese University, Jdeidet El-Matn 1202, Lebanon
| | - Jean Marc Sabatier
- Institute of NeuroPhysiopathology, Aix-Marseille University, CNRS, INP, 13385 Marseille, France;
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22
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Kouhpayeh HR, Tabasi F, Dehvari M, Naderi M, Bahari G, Khalili T, Clark C, Ghavami S, Taheri M. Association between angiotensinogen (AGT), angiotensin-converting enzyme (ACE) and angiotensin-II receptor 1 (AGTR1) polymorphisms and COVID-19 infection in the southeast of Iran: a preliminary case-control study. TRANSLATIONAL MEDICINE COMMUNICATIONS 2021; 6:26. [PMID: 34805533 PMCID: PMC8596349 DOI: 10.1186/s41231-021-00106-0] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/07/2021] [Accepted: 10/31/2021] [Indexed: 06/13/2023]
Abstract
BACKGROUND The COVID-19 pandemic remains an emerging public health crisis with serious adverse effects. The disease is caused by severe acute respiratory syndrome coronavirus-2 (SARS-CoV--2) infection, targeting angiotensin-converting enzyme-2 (ACE2) receptor for cell entry. However, changes in the renin-angiotensin system (RAS) balance alter an individual's susceptibility to COVID-19 infection. We aimed to evaluate the association between AGT rs699 C > T, ACE rs4646994 I/D, and AGTR1 rs5186 C > A variants and the risk of COVID-19 infection and the severity in a sample of the southeast Iranian population. METHODS A total of 504 subjects, including 258 COVID-19 positives, and 246 healthy controls, were recruited. Genotyping of the ACE gene rs4646994, and AGT rs699, and AGTR1 rs5186 polymorphisms was performed by polymerase chain reaction (PCR) and PCR-restriction fragment length polymorphism (PCR-RFLP), respectively. RESULTS Our results showed that the II genotype of ACE rs4646994 and the I allele decreased the risk of COVID-19 infection. Moreover, we found that the TC genotype and C allele of AGT rs699 increased the risk of COVID-19 infection. The AGTR1 rs5186 was not associated with COVID-19 infection. Also, we did not find any association between these polymorphisms and the severity of the disease. However, we found a significantly higher age and prevalence of diabetes and hypertension in patients with severe disease than a non-severe disease. CONCLUSIONS These findings suggest that ACE rs4646994 and AGT rs699 polymorphisms increase the risk of COVID-19 infection in a southeast Iranian population.
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Affiliation(s)
- Hamid Reza Kouhpayeh
- Infectious Diseases and Tropical Medicine Research Center, Resistant Tuberculosis Institute, Zahedan University of Medical Sciences, Zahedan, Iran
| | - Farhad Tabasi
- Department of Physiology, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran
- Department of Clinical Biochemistry, School of Medicine, Zahedan University of Medical Sciences, Zahedan, Iran
| | - Mohammad Dehvari
- Genetics of Non-communicable Disease Research Center, Zahedan University of Medical Sciences, Zahedan, Iran
| | - Mohammad Naderi
- Infectious Diseases and Tropical Medicine Research Center, Resistant Tuberculosis Institute, Zahedan University of Medical Sciences, Zahedan, Iran
| | - Gholamreza Bahari
- Children and Adolescent Health Research Center, Resistant Tuberculosis Institute, Zahedan University of Medical Sciences, Zahedan, Iran
| | - Tahereh Khalili
- Department of Clinical Biochemistry, School of Medicine, Zahedan University of Medical Sciences, Zahedan, Iran
| | - Courtney Clark
- Department of Human Anatomy and Cell Science, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB Canada
| | - Saeid Ghavami
- Department of Human Anatomy and Cell Science, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB Canada
| | - Mohsen Taheri
- Genetics of Non-communicable Disease Research Center, Zahedan University of Medical Sciences, Zahedan, Iran
- Department of Genetic, School of Medicine, Zahedan University of Medical Sciences, Zahedan, 9816743463 Iran
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23
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Li S, Sarangarajan R, Jun T, Kao YH, Wang Z, Hao K, Schadt E, Kiebish MA, Granger E, Narain NR, Chen R, Schadt EE, Li L. In-hospital use of ACE inhibitors/angiotensin receptor blockers associates with COVID-19 outcomes in African American patients. J Clin Invest 2021; 131:e151418. [PMID: 34411004 DOI: 10.1172/jci151418] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2021] [Accepted: 08/18/2021] [Indexed: 12/14/2022] Open
Abstract
BACKGROUNDThe angiotensin-converting enzyme (ACE) D allele is more prevalent among African Americans compared with other races and ethnicities and has previously been associated with severe coronavirus disease 2019 (COVID-19) pathogenesis through excessive ACE1 activity. ACE inhibitors/angiotensin receptor blockers (ACE-I/ARB) may counteract this mechanism, but their association with COVID-19 outcomes has not been specifically tested in the African American population.METHODSWe identified 6218 patients who were admitted into Mount Sinai hospitals with COVID-19 between February 24 and May 31, 2020, in New York City. We evaluated whether the outpatient and in-hospital use of ACE-I/ARB is associated with COVID-19 in-hospital mortality in an African American compared with non-African American population.RESULTSOf the 6218 patients with COVID-19, 1138 (18.3%) were ACE-I/ARB users. In a multivariate logistic regression model, ACE-I/ARB use was independently associated with a reduced risk of in-hospital mortality in the entire population (OR, 0.655; 95% CI, 0.505-0.850; P = 0.001), African American population (OR, 0.44; 95% CI, 0.249-0.779; P = 0.005), and non-African American population (OR, 0.748, 95% CI, 0.553-1.012, P = 0.06). In the African American population, in-hospital use of ACE-I/ARB was associated with improved mortality (OR, 0.378; 95% CI, 0.188-0.766; P = 0.006), whereas outpatient use was not (OR, 0.889; 95% CI, 0.375-2.158; P = 0.812). When analyzing each medication class separately, ARB in-hospital use was significantly associated with reduced in-hospital mortality in the African American population (OR, 0.196; 95% CI, 0.074-0.516; P = 0.001), whereas ACE-I use was not associated with impact on mortality in any population.CONCLUSIONIn-hospital use of ARB was associated with a significant reduction in in-hospital mortality among COVID-19-positive African American patients.FUNDINGNone.
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Affiliation(s)
| | | | - Tomi Jun
- Sema4, Stamford, Connecticut, USA
| | | | | | - Ke Hao
- Sema4, Stamford, Connecticut, USA
| | | | | | | | | | - Rong Chen
- Sema4, Stamford, Connecticut, USA.,Department of Genetics and Genomic Sciences, the Icahn Institute for Genomics and Multiscale Biology, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Eric E Schadt
- Sema4, Stamford, Connecticut, USA.,Department of Genetics and Genomic Sciences, the Icahn Institute for Genomics and Multiscale Biology, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Li Li
- Sema4, Stamford, Connecticut, USA.,Department of Genetics and Genomic Sciences, the Icahn Institute for Genomics and Multiscale Biology, Icahn School of Medicine at Mount Sinai, New York, New York, USA
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24
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Shafiee S, Cegolon L, Khafaei M, Gholami N, Zhao S, Khalesi N, Moosavian H, Fathi S, Izadi M, Ghadian A, Javanbakht M, Javanbakht A, Akhavan-Sigari R. Gastrointestinal cancers, ACE-2/TMPRSS2 expression and susceptibility to COVID-19. Cancer Cell Int 2021; 21:431. [PMID: 34399734 PMCID: PMC8365127 DOI: 10.1186/s12935-021-02129-x] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2021] [Accepted: 07/30/2021] [Indexed: 12/22/2022] Open
Abstract
Recent studies on the pathophysiology of COVID-19 are indicating that the Angiotensin convertase enzyme 2 (ACE-2) and transmembrane serine protease 2 (TMPRSS2) can act as a major component in the fusion of SARS-Cov-2 with target cells. It has also been observed that the expression of ACE-2 and TMPRSS2 can be altered in malignancies. Shedding light on this matter could be crucial since the COVID-19 pandemic interfered with many gastrointestinal cancer screening programs. Herein we discuss the possibility of severe forms of COVID-19 in patients with gastrointestinal cancers due to the gastrointestinal entry route of SARS-CoV-2 into the human body. The disruption of cancer screening programs caused by the current COVID-19 pandemic could therefore have massive negative health impact on patients affected by gastrointestinal malignancies.
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Affiliation(s)
- Sepehr Shafiee
- Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Luca Cegolon
- Public Health Department, Local Health Unit N.2 "Marca Trevigiana", 31100, Treviso, Italy
| | - Mostafa Khafaei
- Human Genetics Research Center, Baqiyatallah University of Medical Sciences, Tehran, Iran
| | - Nasrin Gholami
- Hematology and Oncology Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Shi Zhao
- JC School of Public Health and Primary Care, Chinese University of Hong Kong, Hong Kong, China
| | - Nasrin Khalesi
- Department of Pediatrics, Iran University of Medical Sciences, Tehran, Iran
| | - Hamidreza Moosavian
- Department of Clinical Pathology, Faculty of Veterinary Medicine, University of Tehran, Tehran, Iran
| | - Saeid Fathi
- Department of Parasite Vaccine Research and Production, Razi Vaccine and Serum Research Institute, Agriculture Research, Education and Extension Organization (AREEO), Karaj, Iran
| | - Morteza Izadi
- Health Research Center, Baqiyatallah University of Medical Sciences, Tehran, Iran
| | - Alireza Ghadian
- Nephrology and Urology Research Center, Baqiyatallah University of Medical Sciences, Tehran, Iran
| | - Mohammad Javanbakht
- Nephrology and Urology Research Center, Baqiyatallah University of Medical Sciences, Tehran, Iran.
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25
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Mourad D, Azar NS, Azar ST. Diabetic Nephropathy and COVID-19: The Potential Role of Immune Actors. Int J Mol Sci 2021; 22:ijms22157762. [PMID: 34360529 PMCID: PMC8346171 DOI: 10.3390/ijms22157762] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2021] [Revised: 06/19/2021] [Accepted: 07/01/2021] [Indexed: 12/17/2022] Open
Abstract
Nowadays, type II diabetes mellitus, more specifically ensuing diabetic nephropathy, and severe COVID-19 disease are known to be closely associated. The exact mechanisms behind this association are less known. An implication for the angiotensin-converting enzyme 2 remains controversial. Some researchers have started looking into other potential actors, such as neuropilin-1, mitochondrial glutathione, vitamin D, and DPP4. In particular, neuropilin-1 seems to play an important role in the underlying mechanism linking COVID-19 and diabetic nephropathy. We suggest, based on the findings in this review, that its up-regulation in the diabetic kidney facilitates viral entry in this tissue, and that the engagement of both processes leads to a depletion of neuropilin-1, which was demonstrated to be strongly associated with the pathogenesis of DN. More studies are needed to confirm this hypothesis, and research should be directed towards elucidating the potential roles of all these suggested actors and eventually discovering new therapeutic strategies that could reduce the burden of COVID-19 in patients with diabetic nephropathy.
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Affiliation(s)
- Diane Mourad
- Department of Internal Medicine, Endocrinology Division, Faculty of Medicine and Medical Center, American University of Beirut, Beirut 11-0236, Lebanon;
| | - Nadim S. Azar
- Department of Anatomy, Cell Biology, and Physiological Sciences, Faculty of Medicine and Medical Center, American University of Beirut, Beirut 11-0236, Lebanon;
| | - Sami T. Azar
- Department of Internal Medicine, Endocrinology Division, Faculty of Medicine and Medical Center, American University of Beirut, Beirut 11-0236, Lebanon;
- Endocrinology, Diabetes and Metabolism Division, American University of Beirut Medical Center, Beirut 11-0236, Lebanon
- Correspondence: ; Tel.: +961-323-4250
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26
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Racial and Ethnic Disparities in Years of Potential Life Lost Attributable to COVID-19 in the United States: An Analysis of 45 States and the District of Columbia. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18062921. [PMID: 33809240 PMCID: PMC8000338 DOI: 10.3390/ijerph18062921] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/28/2021] [Revised: 02/15/2021] [Accepted: 03/08/2021] [Indexed: 12/17/2022]
Abstract
The coronavirus disease 2019 (COVID-19) epidemic in the United States has disproportionately impacted communities of color across the country. Focusing on COVID-19-attributable mortality, we expand upon a national comparative analysis of years of potential life lost (YPLL) attributable to COVID-19 by race/ethnicity (Bassett et al., 2020), estimating percentages of total YPLL for non-Hispanic Whites, non-Hispanic Blacks, Hispanics, non-Hispanic Asians, and non-Hispanic American Indian or Alaska Natives, contrasting them with their respective percent population shares, as well as age-adjusted YPLL rate ratios—anchoring comparisons to non-Hispanic Whites—in each of 45 states and the District of Columbia using data from the National Center for Health Statistics as of 30 December 2020. Using a novel Monte Carlo simulation procedure to perform estimation, our results reveal substantial racial/ethnic disparities in COVID-19-attributable YPLL across states, with a prevailing pattern of non-Hispanic Blacks and Hispanics experiencing disproportionately high and non-Hispanic Whites experiencing disproportionately low COVID-19-attributable YPLL. Furthermore, estimated disparities are generally more pronounced when measuring mortality in terms of YPLL compared to death counts, reflecting the greater intensity of the disparities at younger ages. We also find substantial state-to-state variability in the magnitudes of the estimated racial/ethnic disparities, suggesting that they are driven in large part by social determinants of health whose degree of association with race/ethnicity varies by state.
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27
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Calabrese C, Annunziata A, Coppola A, Pafundi PC, Guarino S, Di Spirito V, Maddaloni V, Pepe N, Fiorentino G. ACE Gene I/D Polymorphism and Acute Pulmonary Embolism in COVID19 Pneumonia: A Potential Predisposing Role. Front Med (Lausanne) 2021; 7:631148. [PMID: 33585520 PMCID: PMC7874110 DOI: 10.3389/fmed.2020.631148] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2020] [Accepted: 12/23/2020] [Indexed: 12/19/2022] Open
Abstract
Most recent studies have stressed a high risk of thromboembolism in patients with SARS-CoV-2 infection, particularly in those with severe COVID-19 pneumonia. Counterbalance between angiotensin-converting-enzyme (ACE) and ACE2 activities in COVID-19 disease may be crucially involved in the thrombo-inflammatory process. Currently, no study has investigated ACE I/D polymorphism involvement in COVID-19 disease complicated by pulmonary embolism, hence the aim of the present pilot study. This is a retrospective, single-center observational case-control study, conducted at the Sub-Intensive Care Unit of A.O.R.N. Ospedali dei Colli, Cotugno Hospital, Naples (Italy). We included 68 subjects with severe/critical COVID-19 pneumonia. COVID-19 patients were divided according to occurrence of PE (PE+, n = 25) or absence of thromboembolic complications (PE−, n = 43). Assessment of ACE I/D polymorphisms showed a statistically significant difference between PE+ and PE− patients (p = 0.029). Particularly, prevalence of D/D homozygous polymorphism was significantly higher in PE+ COVID-19 patients than in PE− (72 vs. 46.5%; p = 0.048), while heterozygote I/D polymorphism was significantly lower expressed in PE+ patients than in PE− (16 vs. 48.8%; p = 0.009). Computed tomographic pulmonary angiography showed predominantly mono/bilateral sub-segmental embolisms. In conclusion, our findings let us hypothesize a genetic susceptibility to thromboembolism in COVID-19 disease. ACE D/D polymorphism might represent a genetic risk factor, although studies on larger populations are needed.
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Affiliation(s)
- Cecilia Calabrese
- Department of Translational Medical Sciences, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Anna Annunziata
- Department of Intensive Care, A.O.R.N. Ospedali dei Colli, Naples, Italy
| | - Antonietta Coppola
- Department of Intensive Care, A.O.R.N. Ospedali dei Colli, Naples, Italy
| | - Pia Clara Pafundi
- Department of Advanced Medical and Surgical Sciences, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Salvatore Guarino
- Department of Radiodiagnostic, A.O.R.N. Ospedali dei Colli, Naples, Italy
| | | | - Valeria Maddaloni
- Molecular Genomics Lab, Chemical Biochemistry Unit, A.O.R.N. Ospedali dei Colli, Naples, Italy
| | - Nicola Pepe
- Molecular Genomics Lab, Chemical Biochemistry Unit, A.O.R.N. Ospedali dei Colli, Naples, Italy
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Íñiguez M, Pérez-Matute P, Villoslada-Blanco P, Recio-Fernandez E, Ezquerro-Pérez D, Alba J, Ferreira-Laso ML, Oteo JA. ACE Gene Variants Rise the Risk of Severe COVID-19 in Patients With Hypertension, Dyslipidemia or Diabetes: A Spanish Pilot Study. Front Endocrinol (Lausanne) 2021; 12:688071. [PMID: 34489863 PMCID: PMC8417306 DOI: 10.3389/fendo.2021.688071] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/03/2021] [Accepted: 08/05/2021] [Indexed: 01/28/2023] Open
Abstract
Coronavirus disease 19 (COVID-19) caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection continues to scale and threaten human health and public safety. It is essential to identify those risk factors that lead to a poor prognosis of the disease. A predisposing host genetic background could be one of these factors that explain the interindividual variability to COVID-19 severity. Thus, we have studied whether the rs4341 and rs4343 polymorphisms of the angiotensin converting enzyme (ACE) gene, key regulator of the renin-aldosterone-angiotensin system (RAAS), could explain the different outcomes of 128 COVID-19 patients with diverse degree of severity (33 asymptomatic or mildly symptomatic, 66 hospitalized in the general ward, and 29 admitted to the ICU). We found that G allele of rs4341 and rs4343 was associated with severe COVID-19 in hypertensive patients, independently of gender (p<0.05). G-carrier genotypes of both polymorphisms were also associated with higher mortality (p< 0.05) and higher severity of COVID-19 in dyslipidemic (p<0.05) and type 2 diabetic patients (p< 0.01). The association of G alleles with disease severity was adjusted for age, sex, BMI and number of comorbidities, suggesting that both the metabolic comorbidities and the G allele act synergistically on COVID-19 outcome. Although we did not find a direct association between serum ACE levels and COVID-19 severity, we found higher levels of ACE in the serum of patients with the GG genotype of rs4341 and rs4343 (p<0.05), what could explain the higher susceptibility to develop severe forms of the disease in patients with the GG genotype, in addition to hypertension and dyslipidemia. In conclusion, our preliminary study suggests that the G-containing genotypes of rs4341 and rs4343 confer an additional risk of adverse COVID-19 prognosis. Thus, rs4341 and rs4343 polymorphisms of ACE could be predictive markers of severity of COVID-19 in those patients with hypertension, dyslipidemia or diabetes. The knowledge of these genetic data could contribute to precision management of SARS-CoV-2 infected patients when admitted to hospital.
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Affiliation(s)
- María Íñiguez
- Infectious Diseases, Microbiota and Metabolism Unit, Infectious Diseases Department, Center for Biomedical Research of La Rioja (CIBIR), Logroño, Spain
| | - Patricia Pérez-Matute
- Infectious Diseases, Microbiota and Metabolism Unit, Infectious Diseases Department, Center for Biomedical Research of La Rioja (CIBIR), Logroño, Spain
| | - Pablo Villoslada-Blanco
- Infectious Diseases, Microbiota and Metabolism Unit, Infectious Diseases Department, Center for Biomedical Research of La Rioja (CIBIR), Logroño, Spain
| | - Emma Recio-Fernandez
- Infectious Diseases, Microbiota and Metabolism Unit, Infectious Diseases Department, Center for Biomedical Research of La Rioja (CIBIR), Logroño, Spain
| | - Diana Ezquerro-Pérez
- Infectious Diseases Department, Hospital Universitario San Pedro, Logroño, Spain
| | - Jorge Alba
- Infectious Diseases Department, Hospital Universitario San Pedro, Logroño, Spain
| | - M. Lourdes Ferreira-Laso
- Department of Anesthesiology and Postoperative Care, Hospital Universitario San Pedro, Logroño, Spain
| | - José A. Oteo
- Infectious Diseases, Microbiota and Metabolism Unit, Infectious Diseases Department, Center for Biomedical Research of La Rioja (CIBIR), Logroño, Spain
- Infectious Diseases Department, Hospital Universitario San Pedro, Logroño, Spain
- *Correspondence: José A. Oteo,
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