Introduction
The renin–angiotensin–aldosterone system (RAAS), a metabolic cascade regulating pressure and circulating blood volume, has been considered the main system involved in the pathogenesis of severe lung injury and organs decline in COVID-19 patients. The angiotensin I-converting enzyme (
ACE1
), angiotensin-converting enzyme 2 (
ACE2
), angiotensinogen (AGT) and receptors angiotensin II receptor type 1 (
AGTR1
) are key factors for SARS-CoV-2 entering in the cells, sodium and water retention with an increase blood pressure, promotion of fibrotic and inflammatory phenomena resulting in a cytokine storm.
Methods
In this pilot study, the frequencies of six polymorphisms in the
ACE1, ACE2, AGT
and
AGTR1
genes were analysed in symptomatic patients affected by COVID-19 and compared with the results obtained from asymptomatic subjects.
Results
Thus, we have identified that rs2074192 (
ACE2
), rs1799752 (
ACE1
) and rs699 (
AGT
) SNPs could potentially be a valuable tool for predicting the clinical outcome of SARS-CoV-2 infected patients. A genetic predisposition may be prospected for severe internal organ damages and poor prognosis in patients with COVID-19 disease, as observed in symptomatic vs asymptomatic.
Conclusion
This study provides evidence that analysis of RAAS polymorphisms could be considered the key point in understanding and predicting the SARS-CoV-2 course infection.