ACE Polymorphism and Clinical Outcomes in Iranian Patients with COVID-19

Abstract

Background: The renin–angiotensin system may contribute to the pathogenesis of infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). A growing body of conflicting evidence suggests that the angiotensin-converting enzyme (ACE) insertion/deletion (I/D) polymorphism may be a risk factor for coronavirus disease 2019 (COVID-19). Objectives: This study aimed to evaluate the potential association between ACE I/D alleles and the severity of COVID-19 among Iranian patients. Methods: In this cross-sectional study, 80 patients with mild or severe COVID-19 and 20 healthy controls were evaluated for the ACE I/D polymorphism. Whole blood samples were used for DNA extraction, and the ACE I/D polymorphism was assessed using polymerase chain reaction, followed by electrophoresis on a 1% agarose gel. Results: The mean age of the patients was 54 ± 17 years, and 54 (67.5%) were men. Diabetes was the most common underlying disorder. Among the patients, 20 (25%) had the ACE II genotype, 47 (58.7%) had the ACE DI genotype, and 13 (16.2%) had the ACE DD genotype. No statistically significant association was observed between ACE alleles and COVID-19 severity (P > 0.05). Conclusions: No differences in ACE I/D allele frequencies were identified among patients with severe COVID-19, patients with mild COVID-19, and healthy controls. However, given the limited sample size and the lack of adjustment for potential confounders, this finding should be interpreted cautiously and does not rule out a true association.