ArticleClinical immunology (Orlando, Fla.)2020
Epigenetic dysregulation of ACE2 and interferon-regulated genes might suggest increased COVID-19 susceptibility and severity in lupus patients.
Article in Clinical immunology (Orlando, Fla.), 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 174 papers, 3 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
174 citing papers in PubMed, 3 syntheses or guidelines pooled it, 269 citations in OpenAlex.
- Genetic and Epigenetic Determinants of COVID-19 Susceptibility: A Systematic Review.Current medicinal chemistry · 2025Pooled it
- Impact of COVID-19 on individual mental health and maternal health services in Ethiopia: systematic review and meta-analysis.Frontiers in public health · 2024Pooled it
- Impact of COVID-19 pandemic on mental health in the general population: A systematic review.Journal of affective disorders · 2020Pooled it
- Epigenetic and microRNA-mediated regulation of pulmonary fibrosis and immune dysregulation in fatal COVID-19.Molecular medicine (Cambridge, Mass.) · 2026Article
- Inhibition of SARS-CoV-2 spike S1-ACE2 binding interaction and downregulation of ACE2 gene expression by Malaysian stingless bee honey and its bioactive compound, stilbamidine (SDC).Molecular biology reports · 2026Article
- DNA methylation-based epigenetic clocks highlight immune-driven aging acceleration in COVID-19 across diverse populations.Biogerontology · 2025Article
- Article
- Harnessing Epigenetics: Innovative Approaches in Diagnosing and Combating Viral Acute Respiratory Infections.Pathogens (Basel, Switzerland) · 2025Review
- Angiotensin receptor blockers modulate the lupus CD4+ T cell epigenome characterized by TNF family-linked signaling.JCI insight · 2024Article
- Unveiling the Interplay-Vitamin D and ACE-2 Molecular Interactions in Mitigating Complications and Deaths from SARS-CoV-2.Biology · 2024Review
- The Role of RIN3 Gene in Alzheimer's Disease Pathogenesis: a Comprehensive Review.Molecular neurobiology · 2024Review
- Suicide in Hong Kong during the COVID-19 pandemic: an observational study.BMJ public health · 2024Article
- Mendelian randomization and Bayesian model averaging of autoimmune diseases and Long COVID.Frontiers in genetics · 2024Article
- Epigenetic perspectives associated with COVID-19 infection and related cytokine storm: an updated review.Infection · 2023Review
- COVID-19-Omics Report: From Individual Omics Approaches to Precision Medicine.Reports (MDPI) · 2023Review
- Featured immune characteristics of COVID-19 and systemic lupus erythematosus revealed by multidimensional integrated analyses.Inflammation research : official journal of the European Histamine Research Society ... [et al.] · 2023Article
- Review
- Systemic lupus erythematosus: latest insight into etiopathogenesis.Rheumatology international · 2023Review
- Article
- Involvement of epigenetics in affecting host immunity during SARS-CoV-2 infection.Biochimica et biophysica acta. Molecular basis of disease · 2023Review
114 more citing papers are in PubMed but not listed here.
Corrections and comments
- Update of
Authors and funding
4 authors at 4 institutions in 2 countries.
Funding
Abstract
Infection caused by SARS-CoV-2 can result in severe respiratory complications and death. Patients with a compromised immune system are expected to be more susceptible to a severe disease course. In this report we suggest that patients with systemic lupus erythematous might be especially prone to severe COVID-19 independent of their immunosuppressed state from lupus treatment. Specifically, we provide evidence in lupus to suggest hypomethylation and overexpression of ACE2, which is located on the X chromosome and encodes a functional receptor for the SARS-CoV-2 spike glycoprotein. Oxidative stress induced by viral infections exacerbates the DNA methylation defect in lupus, possibly resulting in further ACE2 hypomethylation and enhanced viremia. In addition, demethylation of interferon-regulated genes, NFκB, and key cytokine genes in lupus patients might exacerbate the immune response to SARS-CoV-2 and increase the likelihood of cytokine storm. These arguments suggest that inherent epigenetic dysregulation in lupus might facilitate viral entry, viremia, and an excessive immune response to SARS-CoV-2. Further, maintaining disease remission in lupus patients is critical to prevent a vicious cycle of demethylation and increased oxidative stress, which will exacerbate susceptibility to SARS-CoV-2 infection during the current pandemic. Epigenetic control of the ACE2 gene might be a target for prevention and therapy in COVID-19.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.