Association of high level gene expression of ACE2 in adipose tissue with mortality of COVID-19 infection in obese patients

Sammy Al-Benna

doi:10.1016/j.obmed.2020.100283

Association of high level gene expression of ACE2 in adipose tissue with mortality of COVID-19 infection in obese patients

Obes Med. 2020 Sep:19:100283. doi: 10.1016/j.obmed.2020.100283. Epub 2020 Jul 18.

Author

Sammy Al-Benna¹

Affiliation

¹ Division of Plastic and Reconstructive Surgery, Faculty of Medicine and Health Sciences, Stellenbosch University and Tygerberg Academic Hospital, Francie van Zijl Drive, PO Box 241, Cape Town, 8000, South Africa.

Abstract

Introduction: Obese patients have an increased risk of COVID-19 critical illness leading to ICU admission or death compared to normal weight individuals. SARS-CoV-2 binding to angiotensin-converting enzyme 2 (ACE2) receptor is a critical step mediate virus entry into target cells. Articles have alluded that the level of ACE2 gene expression in adipose tissue is higher than lung tissue, but a PubMed search found no results in articles to demonstrate this. The aim of this study was to investigate ACE2 gene expression in adipose tissue and lung tissue using a public database.

Material and methods: A search of a public gene expression database to investigate ACE2 gene expression in human tissues.

Results: ACE2 gene expression was present in both visceral and subcutaneous adipose tissues. The gene expression profile demonstrated that ACE2 gene expression was higher in human visceral and subcutaneous adipose tissues than human lung tissue.

Conclusion: This study demonstrates that ACE2 gene expression is higher in visceral and subcutaneous adipose tissue than that in lung tissue, a major target tissue affected by SARS-CoV-2 infection. This suggests a mechanism by which excess adiposity may drive greater infection severity in patients with COVID-19.

Keywords: ACE, angiotensin converting enzyme; ACE2, angiotensin converting enzyme-2; AT(1–7), angiotensin (1–7); AT1, angiotensin 1; AT2, angiotensin 2; Adipose tissue; Angiotensin converting enzyme 2 receptor; COVID-19; COVID-19, Coronavirus disease 2019; Coronavirus; SARS CoV, severe acute respiratory syndrome coronavirus; SARS CoV-2, severe acute respiratory syndrome coronavirus-2; Severe acute respiratory syndrome coronavirus 2.