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This study evaluated the level of expression of angiotensin-converting enzyme 2 receptor (ACE2) in patients with diabetes and nonalcoholic liver disease (NAFLD), with a view to link increased expression to severity of COVID-19 in these patients. Hepatic ACE2 mRNA levels were increased in males compared with females, and increased ACE2 expression was seen with increased fat accumulation in the liver. Elevated ACE2 expression was also seen in diabetic livers. No association of TMPRSS2 or furin expression with diabetes or hepatic fat content was found.
An increased expression of hepatic ACE2 was seen in the livers of patients who were male, were older, had diabetes, or had NAFL. The increased expression of ACE2 may be related to the adverse course of COVID-19 in these patients and their susceptibility for hepatic complications.
This abstract is available on the publisher's site.
The current pandemic of severe acute respiratory syndrome coronavirus 2 (SARSCoV-2)-induced disease (coronavirus disease 2019 [COVID-19]) is a major global threat. Although most infected patients have a mild course, a relevant proportion of approximately 20% develop a severe and often lethal condition. Recent findings demonstrate that COVID-19 is a multiorgan disease. In addition to the characteristic pneumonia, it affects heart, kidney, pancreas, the coagulation system, and liver. Major risk factors for severe COVID-19 with multiorgan complications include male sex, older age (.65 years), cardiovascular and chronic lung disease, and especially diabetes (1,2). However, it is still unclear why these conditions predispose to a severe course of COVID-19.