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Coronavirus: A Potential Genetic Link

Written by Mathew Eng, PharmD | Last updated:
Puya Yazdi
Medically reviewed by
Puya Yazdi, MD | Written by Mathew Eng, PharmD | Last updated:

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Note that each number in parentheses [1, 2, 3, etc.] is a clickable link to peer-reviewed scientific studies. A plus sign next to the number “[1+, 2+, etc...]” means that the information is found within the full scientific study rather than the abstract.

This article is for informational purposes only. The current coronavirus outbreak is an ongoing event and certain details may change as new information comes to light.

None of the information here should be taken as medical advice. If you suspect you may have any kind of infection, seek medical help immediately.

This article will focus on genetic factors that may affect the body’s response to COVID-19. For more information on the disease, including symptoms and prevention, check out these resources from the Centers for Disease Control and Prevention.

Coronavirus Disease (COVID-19)

The current outbreak of coronavirus disease, better known as COVID-19, is a disease caused by an infection of a virus called SARS-CoV-2 (formerly known as 2019-nCoV) [1].

Generally speaking, the large majority of COVID-19 cases are mild and involve cold-like symptoms [1].

However, about 14% of cases are considered severe and 5% of cases result in critical illness, according to preliminary data from Chinese centers [2].

The World Health Organization estimates that about 3.4% of COVID-19 cases have resulted in death globally [3].

While these numbers will likely change as we learn more about the disease, it appears that COVID-19 may affect certain groups of people differently.

Initial research suggests that age, gender, geographic location, and underlying health conditions may all influence the severity and susceptibility to COVID-19 [1, 2].

Interestingly enough, there is some evidence that genetics may also play a role in disease severity. More specifically, the ACE2 gene may have important interactions with the coronavirus [4, 5].

Coronavirus and ACE2

Coronavirus actually refers to a group of viruses, including SARS, MERS, and SARS-CoV-2 (the virus that is responsible for the current outbreak of COVID-19) [6].

Viruses, in general, work by invading the body’s own cells and using the components inside to help replicate and spread.

The SARS-CoV-2 virus, in particular, appears to enter human cells by attaching to the ACE2 receptor, which serves as an entry point for the virus [6].

Normally, the ACE2 receptor plays an important role in regulating the body’s blood pressure and fluid balance [7].

ACE2 receptors can be found in the body’s airways, making them a target for several types of viruses [7].

How Do Genetics Affect Coronavirus?

One recent study suggests there may be a connection between genetics and the body’s response or susceptibility to SARS-CoV-2 [4].

Researchers from this study identified a number of ACE2 variants that are significantly more common in East Asian populations compared to other groups.

Some of these variants (also known as SNPs) include rs4646127, rs2158082, rs5936011, rs6629110, rs4830983, and rs5936029 [4].

In all these variants, the major allele (more common variant) is present in over 95% of people from East Asian populations [4].

In contrast, less than 65% of European populations carry this major allele [4].

The major allele in all these variants is associated with greater expression of ACE2, which researchers theorize may increase susceptibility or severity of COVID-19 because this genetic variant potentially provides more entry points for the virus [4].

However, further research is required to confirm a link between the ACE2 gene and COVID-19.

Researchers from this study also tried to identify any ACE2 gene variants that may prevent the virus from attaching to the body’s cells, but no evidence was found [4].

Treatment of COVID-19

CDC Guidelines

When to Seek Medical Advice

If you are experiencing symptoms of COVID-19, seek medical advice at once. If your city, state, or country has communicated a protocol to follow to get tested, follow those instructions carefully. If not, call your doctor to determine next steps.

The CDC has advised that most cases of COVID-19 should be treated at home, seeking a doctor’s advice by phone only. The reason for this advice is that COVID-19 is highly contagious, and even physically entering a doctor’s office could spread the virus to at-risk patients. However, even if you have a mild case, your local health department will want to know whether you have COVID-19. Therefore, people with symptoms of respiratory coronavirus infection should call their doctors regardless of the severity of those symptoms [8].

Home Care

Unfortunately, there are currently no vaccines, drugs, or investigational products approved by the FDA to treat COVID-19. If you are sick or caring for someone at home, the CDC recommends having your healthcare provider’s phone number on hand and carefully monitoring symptoms in case they get worse. Emergency warning signs include difficulty breathing, persistent pain or pressure in the chest, confusion, or a bluish tint in the lips or face [9, 10].

As part of any regimen for preventing infection and recovering from illness, it is extremely important to focus on hygiene and rest.

Click here for the CDC’s complete guide to caring for someone with COVID-19 at home.

Ongoing Research

Currently, a strong effort is being made by researchers to identify potential agents for the prevention or treatment of COVID-19 [11, 12].

In particular, the ACE2 receptor has received attention because of its potential as an entry point for SARS-CoV-2. Researchers are exploring treatments that block the binding of viruses to the ACE2 receptor [11].

One example are treatments that block TMPRSS2, an enzyme that facilitates the binding process between the ACE2 receptor and SARS-CoV-2. Preliminary cell studies of TMPRSS2 inhibitors have shown promising results [13, 11].

Other potential treatments include other agents that can block the ACE2 receptor or the development of vaccines [14, 11].

However, these treatments are all in very early stages of research and it remains to be unseen which may be effective.

About the Author

Mathew Eng

Mathew Eng

Mathew received his PharmD from the University of Hawaii and an undergraduate degree in Biology from the University of Washington.
Mathew is a licensed pharmacist with clinical experience in oncology, infectious disease, and diabetes management. He has a passion for personalized patient care and believes that education is essential to living a healthy life. His goal is to motivate individuals to find ways to manage their chronic conditions.

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