Exploration of the Effect of SNPS (Ace1/Ace2) in the Variability of the Severity of Covid-19 Disease in Hypertensive Patients

Background: ACE2 has been identified as the entry receptor for coronaviruses into human cells, including SARS-COV-2 that causes COVID-19. Since hypertension is a leading comorbidity in non-survivors of COVID-19, we aimed to identify relevant SNPs of ACE1, ACE2 that may associated with increased risk for SARS-CoV-2/SARS-CoV infection and there susceptibility to increase the cardiovascular diseases in hypertensive patients. Methods: Literature was searched in PubMed, Science direct and Google Scholar to identify studies that had either assessed the SNPs of ACE2 gene with SARS-CoV-2/SARS-CoV infection or suggested the SNPs that could possibly regulate ACE2 expression in different human tissues. Then make a list of these SNPs of ACE1 and ACE2 considering as potential candidate for investigating the genetic effects in future studies. Results: In 11 studies analyzed and interpreted, we identified and analyzed 37 mutations that affect ACE1/ACE2 causing an imbalance of the renin agiotensin aldosterone system and modifying the severity of Covid-19 in patients with hypertension. From the studies done so far, we found that there are 20 mutations among the 37 identified that affect the receptors of the renin angiotensin aldosterone system that are directly related to the severity of Covid-19 since they all present P values<0.05. Conclusion: This is the first meta-analysis that gathers all the polymorphisms that affect the receptors of the renin angiotensin aldosterone system, causing an imbalance in the latter and also increasing the expression of this receptor as the main receptor of Covid-19 severity.