Vol. 7, Issue 3, Part C (2024)

Background: Angiotensin converting enzyme (ACE) deletion/deletion polymorphisms represent a marker of thrombosis, increasing thrombosis risk in unpredisposing individuals, especially in severe corona virus disease (COVID-19) pneumonia, and playing a crucial role in early disease progression. This work aimed to investigate the prognostic value of ACE gene polymorphism among COVID-19 individuals developing Streptococcus pneumoniae coinfection.

Methods: The retrospective observational case control study included sixty cases, suffering from COVID-19 pneumoniae hospitalized between December 2021 and March 2022. All participants were categorized equally into two groups: Group (I): cases having COVID-19 were classified into two subgroups [(Ia) (n=6): positive streptococcus pneumoniae coinfection and (Ib) (n=54): negative streptococcus pneumoniae coinfection] and group (II): apparently healthy people as a control group.

Results: Lactate dehydrogenase (LDH), ACE levels, PaO2, bacteriological examination, genotypic distribution of the insertion (I) deletion (D) polymorphism of the ACE showed a significant variation among the analyzed groups (p<0.05). In comparison of demographic, clinical, laboratory data with ACE insertion deletion gene polymorphism were a significant difference regarding pulmonary embolism and ACE. ROC curve which displayed the expected outcome values of ACE I D polymorphism showed 77% sensitivity, 70% specificity. Outcome of COVID19 and outcome with ACE insertion deletion gene polymorphism were a significant difference in comparing outcome of 2 groups (p<0.05).

Conclusions: COVID-19 patients who have the ACE insertion deletion gene polymorphism have poor clinical outcomes. The ACE I/I genotype is protective against severe disease, since cases having the I/I genotype exhibited greater survival rates and those having the D/D genotype are more likely to die at a higher rate.