Worldwide ACE (I/D) polymorphism may affect COVID-19 recovery rate: an ecological meta-regression
Worldwide ACE (I/D) polymorphism may affect COVID-19 recovery rate: an ecological meta-regression
复制标题
DOI：
10.1007/s12020-020-02381-7
复制
发表时间：
2020-06-15
期刊：
影响因子：
3.7
通讯作者：
Hosseini, Ava
中科院分区：
文献类型：
--
作者：
Hatami, Naser;Ahi, Salma;Hosseini, Ava
随着新型冠状病毒(2019-nCoV)的出现，世界各地的研究人员已经开始检测这种疾病的可能发病机制。肾素-血管紧张素系统(RAS)和血管紧张素转换酶作为2019-nCoV致病的可能途径受到了广泛关注。由于寻求寻找作用于这些途径的潜在药物的实验是在早期阶段进行的，因此对新冠肺炎病的患病率与RAS系统涉及的基因的遗传差异之间的关系拥有一个生态世界观可能对该领域有价值。在这方面，我们对血管紧张素转换酶(I/D)基因在受新冠肺炎影响最严重的国家的患病率进行了荟萃分析研究。在荟萃分析中，使用综合荟萃分析软件对来自30个不同国家的48,758名健康受试者进行了116项研究的评估。用随机效应模型合并I/D等位基因频率比。死亡和恢复率的新冠肺炎流行数据被评估为Meta回归分析的纬度。结果显示，随着I/D等位基因频率比的增加，恢复率显著增加(点估计：0.48，可信区间95%：0.05~0.91，P=0.027)。两组死亡率差异无统计学意义(点估计：1.74，可信区间95%：4.5~1.04，p=0.22)。这种生态学观点，加上许多局限性，并不能提供新冠肺炎和RAS系统之间的直接临床相关性，但它显示了潜在的病理生理学联系。我们的结果引起了人们对种族和遗传差异的担忧，这些差异可能会影响目前调查的RAS相关药物在不同地区的有效性。
With the emergence of the Novel Coronavirus (2019-nCoV), researchers worldwide have started detecting the probable pathogenesis of the disease. The renin-angiotensin system (RAS) and angiotensin-converting enzymes have received a good deal of attention as possible pathways involved in 2019-nCoV pathogenesis. As the experiments seeking to find potential medications acting on these pathways are being conducted in the early phases, having an ecological worldview on the relationship between the prevalence of COVID-19 disease and the genetic differences in the genes involved in the RAS system could be valuable for the field. In this regard, we conducted a meta-analysis study of the prevalence of ACE (I/D) genotype in countries most affected by the COVID-19. In the meta-analysis, 48,758 healthy subjects from 30 different countries were evaluated in 116 studies, using the Comprehensive Meta-analysis software. The I/D allele frequency ratio was pooled by a random-effect model. The COVID-19 prevalence data of death and recovery rates were evaluated as the latitudes for the meta-regression analysis. Our results demonstrated that with the increase of the I/D allele frequency ratio, the recovery rate significantly increased (point estimate: 0.48, CI 95%: 0.05-0.91,p = 0.027). However, there was no significant difference in the case of death rate (point estimate: 1.74, CI 95%: 4.5-1.04,p = 0.22). This ecological perspective coupled with many limitations does not provide a direct clinical relevance between the COVID-19 and RAS system, but it shows potential pathophysiological associations. Our results raise concerns about ethnic and genetic differences that could affect the effectiveness of the currently investigated RAS-associated medications in different regions.