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

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