ArticleJournal of racial and ethnic health disparities2021
Ethnic Prevalence of Angiotensin-Converting Enzyme Deletion (D) Polymorphism and COVID-19 Risk: Rationale for Use of Angiotensin-Converting Enzyme Inhibitors/Angiotensin Receptor Blockers.
Article in Journal of racial and ethnic health disparities, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 29 papers, 1 of them a synthesis that pooled it.
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Who cites it
29 citing papers in PubMed, 1 synthesis or guideline pooled it, 57 citations in OpenAlex.
- Relationship between Angiotensin-Converting Enzyme Insertion/Deletion Polymorphism and the Risk of COVID-19: A Meta-Analysis.Journal of the renin-angiotensin-aldosterone system : JRAAS · 2023Pooled it
- Pharmacogenetics of RAS-affecting AGT and ACE variants and the efficacy of Valsartan/HCTZ therapy.Scientific reports · 2026Article
- The synergistic interaction between ACE and TMPRSS2 polymorphisms increases the risk of severe COVID-19.PloS one · 2026Article
- A narrative review of research advancements in pharmacogenetics of cardiovascular disease and impact on clinical implications.NPJ genomic medicine · 2025Review
- Analysis of coinfections in patients with hematologic malignancies and COVID-19 by next-generation sequencing of bronchoalveolar lavage fluid.European journal of medical research · 2024Article
- Polymorphisms in the ACE I/D (Tropical medicine and infectious disease · 2024Article
- Understanding the effects of COVID-19 on patients with diabetic nephropathy: a systematic review.Annals of medicine and surgery (2012) · 2024Article
- Strong association between angiotensin-converting enzyme gene InDel polymorphism and COVID-19 diseases.Medicina clinica (English ed.) · 2023Article
- Interrelationship between COVID-19 and Coagulopathy: Pathophysiological and Clinical Evidence.International journal of molecular sciences · 2023Review
- SARS-CoV-2 infection in the context of Kawasaki disease and multisystem inflammatory syndrome in children.Medical microbiology and immunology · 2023Review
- Association investigations between ACE1 and ACE2 polymorphisms and severity of COVID-19 disease.Molecular genetics and genomics : MGG · 2023Article
- Article
- Angiotensin-converting enzyme 2 rs2285666 polymorphism and clinical parameters as the determinants of COVID-19 severity in Iranian population.International journal of immunogenetics · 2022Article
- Differences in lung function between major race/ethnicity groups following hospitalization with COVID-19.Respiratory medicine · 2022Article
- Considerations for the future: current and future treatment paradigms with mineralocorticoid receptor antagonists-unmet needs and underserved patient cohorts.Kidney international supplements · 2022Review
- Article
- Are angiotensin converting enzyme (ACE1/ACE2) gene variants associated with the clinical severity of COVID-19 pneumonia? A single-center cohort study.Anatolian journal of cardiology · 2022Article
- Article
- The role of angiotensin I converting enzyme insertion/deletion polymorphism in the severity and outcomes of COVID-19 patients.Frontiers in genetics · 2022Article
- Association Between theFrontiers in medicine · 2022Article
Corrections and comments
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Authors and funding
6 authors at 3 institutions in 3 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
rationaleHypertension, obesity and diabetes are major risk factors associated with morbidities underlying COVID-19 infections. Regression analysis correlated presence of ACE insertion/deletion (I/D) polymorphism to COVID-19 incidence and mortality. Furthermore, COVID-19 prevalence correlated to allele frequency of angiotensin-converting enzyme (ACE) deletion (D) polymorphism within the European population.
objectiveHomozygous ACE deletion polymorphism is associated with increase in ACE and angiotensin II (Ang-II), sustained levels can result in inflammation, fibrosis and organ damage. The ACE DD polymorphism is also associated with hypertension, acute respiratory distress and diabetic nephropathy, all considered high risk for COVID-19 infection and outcomes. The study objective was to describe a biological framework associating ethnic prevalence of ACE deletion polymorphism to COVID-19 comorbidities providing rationale for therapeutic utility of ACE-I/ARBs to improve outcomes. METHOD AND
resultsThe Allele Frequency Database (ALFRED) was queried for frequency of rs4646994 representing ACE I/D polymorphism. In a total of 349 worldwide population samples, frequency of ACE D allele was higher in European, Asian, and Africans cohorts. In the USA, the frequency of ACE D allele was higher in non-Hispanic Black compared with non-Hispanic White and Mexican Americans.
conclusionCOVID-19 binding mediated reduction/inactivation of ACE-II can increase ACE/Ang-II signalling pathway and related pathologies. The presence of ACE DD polymorphism with COVID-19 infection likely augments ACE/Ang-II activities, increasing severity of COVID-19 morbidities and impacts outcomes. Thus, ethnic prevalence of ACE DD polymorphism can explain in part the severity of COVID-19 morbidity providing rationale for the use of ACE-I/ARBs to improve outcomes.
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