Association between the ACE I/D Variant and COVID-19 Susceptibility and Severity; a Meta-Analysis

Aims: Several studies investigated the association of ACE I/D polymorphism with the risk and severity of COVID-19 infection.  However, the information in each of the published studies is limited, and the results were inconsistent or even contradictory. Accordingly, this meta-analysis evaluated the association between ACE I/D polymorphism and COVID-19 susceptibility and severity. Materials Methods: Two investigators independently searched the PubMed, Embase, Google Scholar, Scopus, and Science Direct databases. Five studies including 1029 cases and 3561 controls were retrieved to evaluate the association between ACE I/D polymorphism and the risk of COVID-19. Furthermore, a meta-analysis of the correlation between the ACE I/D variant and the severity of infection covered 5 case-control studies, including 264 sever-cases and 447 mild cases. Findings: There was no association between the ACE I/D variant in all genetic models and COVID-19 susceptibility. However, our analysis revealed that there was a significant association between ACE I/D variant in the allele contrast (95% CI=0.5291-0.8353; p 0.001), recessive (95% CI=0.4268-0.9172; p=0.01) and dominant (95% CI=0.3974-0.8092; p=0.001) models and severity of COVID-19. Conclusion: ACE I/D polymorphism is associated with the severity of COVID-19 infection. There is no association between the ACE I/D variant in all genetic models and COVID-19 susceptibility.