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.
【저자키워드】 polymorphism, Pulmonary embolism, Angiotensin II, COVID19 pneumonia, ACE gene, 【초록키워드】 COVID-19, ACE2, Severe COVID-19 pneumonia, Pneumonia, Infection, Italy, Population, COVID-19 disease, activity, Prevalence, Patient, Thromboembolism, genetic susceptibility, assessment, case-control study, retrospective, ACE, I/D polymorphism, COVID-19 patient, high risk, pulmonary angiography, pilot study, subject, statistically significant difference, single-center, unit, homozygous, MOST, significantly lower, genetic risk factor, heterozygote, counterbalance, Occurrence, involved, investigated, conducted, absence, expressed, significantly higher, Naple, patients with SARS-CoV-2, thromboembolic complication, 【제목키워드】 COVID19, pulmonary, Embolism, ACE, role, Potential, I/D,