Angiotensin System Polymorphisms’ in SARS-CoV-2 Positive Patients: Assessment Between Symptomatic and Asymptomatic Patients: A Pilot Study
Concetta Cafiero, Felice Rosapepe, Raffaele Palmirotta, Agnese Re, Maria Pia Ottaiano, Giulio Benincasa, Romina Peroné, Elisa Varriale, Gerardo D’Amato, Andrea Cacciamani, Alessandra Micera, Salvatore Pisconti
Abstract
Introduction: The renin–angiotensin–aldosterone system (RAAS), a metabolic cascade regulating pressure and circulating blood volume, has been considered the main system involved in the pathogenesis of severe lung injury and organs decline in COVID-19 patients. The angiotensin I-converting enzyme ( ACE1 ), angiotensin-converting enzyme 2 ( ACE2 ), angiotensinogen (AGT) and receptors angiotensin II receptor type 1 ( AGTR1 ) are key factors for SARS-CoV-2 entering in the cells, sodium and water retention with an increase blood pressure, promotion of fibrotic and inflammatory phenomena resulting in a cytokine storm. Methods: In this pilot study, the frequencies of six polymorphisms in the ACE1, ACE2, AGT and AGTR1 genes were analysed in symptomatic patients affected by COVID-19 and compared with the results obtained from asymptomatic subjects. Results: Thus, we have identified that rs2074192 ( ACE2 ), rs1799752 ( ACE1 ) and rs699 ( AGT ) SNPs could potentially be a valuable tool for predicting the clinical outcome of SARS-CoV-2 infected patients. A genetic predisposition may be prospected for severe internal organ damages and poor prognosis in patients with COVID-19 disease, as observed in symptomatic vs asymptomatic. Conclusion: This study provides evidence that analysis of RAAS polymorphisms could be considered the key point in understanding and predicting the SARS-CoV-2 course infection. Keywords: ACE , AGT , AGTR1 , RAAS, polymorphisms, SARS-CoV-2, asymptomatic, COVID-19