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PLoS One. 2022 Jan 07;17(1):e0260897. doi: 10.1371/journal.pone.0260897. eCollection 2022.

Association of genetic variations in ACE2, TIRAP and factor X with outcomes in COVID-19.

PloS one

Marissa J M Traets, Roel H T Nijhuis, Servaas A Morré, Sander Ouburg, Jasper A Remijn, Bastiaan A Blok, Bas de Laat, Eefje Jong, Gerarda J M Herder, Aernoud T L Fiolet, Stephan P Verweij

Affiliations

  1. Meander Medical Centre, Department of Internal Medicine, Amersfoort, The Netherlands.
  2. Meander Medical Centre, Department of Medical Microbiology and Medical Immunology, Amersfoort, The Netherlands.
  3. Department of Medical Microbiology and Infection Control, Laboratory of Immunogenetics, Amsterdam UMC, Amsterdam, The Netherlands.
  4. Department of Genetics and Cell Biology, Institute for Public Health Genomics, Research Institute GROW, Faculty of Health, Medicine & Life Sciences, University of Maastricht, Maastricht, The Netherlands.
  5. Meander Medical Centre, Department of Clinical Chemistry, Amersfoort, The Netherlands.
  6. Synapse Research Institute, Maastricht, The Netherlands.
  7. Meander Medical Centre, Department of Pulmonary Disease, Amersfoort, The Netherlands.
  8. Department of Respiratory Medicine, University Medical Centre Utrecht, Utrecht, The Netherlands.

PMID: 34995294 PMCID: PMC8740962 DOI: 10.1371/journal.pone.0260897

Abstract

BACKGROUND: Coronavirus disease 2019 (COVID-19), caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), can manifest with varying disease severity and mortality. Genetic predisposition influences the clinical course of infectious diseases. We investigated whether genetic polymorphisms in candidate genes ACE2, TIRAP, and factor X are associated with clinical outcomes in COVID-19.

METHODS: We conducted a single-centre retrospective cohort study. All patients who visited the emergency department with SARS-CoV-2 infection proven by polymerase chain reaction were included. Single nucleotide polymorphisms in ACE2 (rs2285666), TIRAP (rs8177374) and factor X (rs3211783) were assessed. The outcomes were mortality, respiratory failure and venous thromboembolism. Respiratory failure was defined as the necessity of >5 litres/minute oxygen, high flow nasal oxygen suppletion or mechanical ventilation.

RESULTS: Between March and April 2020, 116 patients (35% female, median age 65 [inter quartile range 55-75] years) were included and treated according to the then applicable guidelines. Sixteen patients (14%) died, 44 patients (38%) had respiratory failure of whom 23 required endotracheal intubation for mechanical ventilation, and 20 patients (17%) developed venous thromboembolism. The percentage of TIRAP polymorphism carriers in the survivor group was 28% as compared to 0% in the non-survivor group (p = 0.01, Bonferroni corrected p = 0.02). Genotype distribution of ACE2 and factor X did not differ between survivors and non-survivors.

CONCLUSION: This study shows that carriage of TIRAP polymorphism rs8177374 could be associated with a significantly lower mortality in COVID-19. This TIRAP polymorphism may be an important predictor in the outcome of COVID-19.

Conflict of interest statement

The authors have declared that no competing interests exist.

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