Background and objective : Insertion/deletion polymorphisms of angiotensin-converting enzyme (ACE) have been previously described in association with adult respiratory distress syndrome (ARDS) and correlated to outcome. The ACE deletion/deletion(D/D)genotype represents a marker of thrombosis in subjects apparently without predisposing factors and/or traditional thrombophilic alterations and increases the risk of venous thromboembolism in subjects in whom a thrombogenic condition occurs. Thrombosis seems to play a role very early in the disease caused by SARS-CoV-2, in particular in those with severe COVID-19 pneumonia. The counterbalance between angiotensin-converting enzyme (ACE) and ACE2 activities in COVID-19 disease may play a crucial role in the thrombo-inflammatory process. We hypothesised that a genetic predisposition could condition the severity and complications of SARS-CoV-2 infection. Materials and methods : We conducted a spontaneous, single centre observational study in the Sub-Intensive Care Unit of A.O.R.N. Ospedali dei Colli, Cotugno Hospital, Naples (Italy). In this study, we performed genetic screening for ACE D/D genotype and other thrombophilic mutations in 20 patients affected by ARDS related to COVID-19 pneumonia, compared to 19 age- and sex-matched healthy controls. Results : All tested patients had multiple polymorphisms and, in particular, a significantly higher prevalence of ACE D/D polymorphism in severe COVID-19 patients Conclusion : We found that the majority of patients who tested positive for ACE D-D genotype and who were not associated with other risk factors for VTE showed an evolution to ARDS. This finding could have a predicting role in the selection of patients more prone to developing severe COVID-19 during clinical observation in emergency department.
【저자키워드】 COVID-19, ARDS, angiotensin converting enzyme, 【초록키워드】 Evolution, SARS-CoV-2, ACE2, Severe COVID-19 pneumonia, Mutation, thrombosis, severe COVID-19, Pneumonia, SARS-COV-2 infection, severity, Genetic, polymorphism, risk, outcome, Italy, risk factor, Venous Thromboembolism, COVID-19 disease, activity, Prevalence, Patient, Genotype, Complication, age, association, Angiotensin-converting enzyme, marker, ACE, distress, Genetic predisposition, VTE, observation, Factor, subject, alteration, syndrome, healthy controls, material, unit, positive, Result, tested, described, performed, affected, caused, the disease, conducted, increase, majority, correlated, significantly higher, hypothesised, Naple, severe COVID-19 patient, 【제목키워드】 angiotensin, Emergency, Factor, Department,