The relationship between the clinical course of SARS-CoV-2 infection with ACE2 and TMPRSS2 expression and polymorphisms

Background
The viral S protein and host ACE2 and TMPRSS2 genetic variations may act as a barrier to viral
infection or determine susceptibility to COVID-19 infection.
Objectives
We investigated the relationship between the expression patterns and polymorphisms of the ACE2
and TMPRSS2 receptor genes associated with COVID-19 and the clinical course of COVID-19
infection.
Material and methods
We studied 147 COVID-19 patients (41 asymptomatic, 53 symptomatic and 53 treated in intensive
care unit (ICU) cases) and 33 healthy controls. ACE2 and TMPRSS2 expressions were determined
using the One-Run RT Q-PCR kit. Genotypic distributions of Single Nucleotide Polymorphisms (SNP)
of ACE2 and TMPRSS2 were obtained by RT-PCR.
Results
The expressions of ACE2 and TMPRSS2 were different between SARS-CoV-2 positive and negative
groups. ACE2 rs714205GG genotype and G-allele showed significant differences in the SARS-CoV-2
positive asymptomatic group. A significant correlation was found between TMPRSS2 rs8134378GA,
rs2070788GA, rs7364083GA and rs9974589AC genotypes and SARS-CoV-2 positivity. The
rs1978124 C-allele and rs8134378 A-allele were significant in the SARS-CoV-2 positive symptomatic
group. TMPRSS2 rs2070788GA was different in all patient groups from the control group. There was a
difference between SARS-CoV-2 positive and negative groups for the CTTA haplotype formed by
ACE2 variants. The AGCAG and AGAAG haplotypes formed by TMPRSS2 variants were more
common in the asymptomatic patient group than in other patient groups.
Conclusions
Identifying the relationship between host genetic variants and COVID-19 susceptibility will contribute to
further studies that will enable new vaccines and potential therapeutic approaches to be applicable.