The contrasting role of nasopharyngeal angiotensin converting enzyme 2 (ACE2) transcription in SARS-CoV-2 infection: A cross-sectional study of people tested for COVID-19 in British Columbia, Canada

January 4, 2021

Aidan M. Nikiforuk Kevin S. Kuchinski David D.W. Twa Christine D. Lukac Hind Sbihi C.Andrew Basham Christian Steidl Natalie A. Prystajecky Agatha N. Jassem Mel Krajden David M. Patrick Inna Sekirov

EBioMedicine The Lancet

SARS-CoV-2 uses ACE2 to enter the cell and TMPRSS2 as a complementary host factor. This study aims to investigate the relationship between nasopharyngeal ACE2 transcription and age in COVID-19 negative participants and those positive, their age, biological sex, soluble ACE2 transcription and TMPRSS2. A cross-sectional sample of people was conducted at the British Columbia Center for Disease Control Public Health Laboratory and gathered 424 participants. No differences were observed in nasal ACE2 expression between young adults and adults 25 years of age and older. The lack of a relationship between nasopharyngeal transcription of ACE2 and progressive aging suggests that the expression of the ACE2 protein in the upper airways may not correlate with the expression of the ACE2 protein in the lower airways. Participants who tested positive for COVID-19 were matched with those who tested negative for age and biological sex to estimate the direct relationship between host gene expression and SARS-CoV-2 test result. Paired analysis demonstrated that the mean transcription of transmembrane ACE2, soluble ACE2, and TMPRSS2 decreased in COVID-19 positive participants, while variation increased. Participant data supporting the findings of this study is available from the British Columbia Ministry of Health.

Nikiforuk A, Kunshinsky K, Twa D The contrasting role of nasopharyngeal angiotensin converting enzyme 2 (ACE2) transcription in SARS-CoV-2 infection: A cross-sectional study of people tested for COVID-19 in British Columbia, Canada. The Lancet 2021; 66. DOI: https://doi.org/10.1016/j.ebiom.2021.103316

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