Review: Nasal gene expression of angiotensin-converting enzyme 2 in children and adults

This retrospective study show age-dependent expression of ACE2 in nasal epithelium, the first point of contact for SARS-CoV-2 and the human body. This may shed light on why children only appear to account for a small proportion of COVID-19 cases. 

  • Angiotensin-converting enzyme 2 (ACE2) is the receptor that severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) uses for host entry. ACE2 gene expression was the focus of this study.
  • Study examined the nasal epithelium from individuals aged 4 to 60 years encountered within the Mount Sinai Health System, New York, New York, during 2015-2018.
  • Samples were collected from individuals with and without asthma for research on nasal biomarkers of asthma.
  • 305 individuals aged 4 to 60 years was balanced with regard to sex (48.9% male). Because the cohort had been recruited to study biomarkers of asthma, 49.8% had asthma.
  • ACE2 gene expression was lowest (mean log2 counts per million, 2.40; 95% CI, 2.07-2.72) in younger children (n = 45) and increased with age, with mean log2 counts per million of 2.77 (95% CI, 2.64-2.90) for older children (n = 185), 3.02 (95% CI, 2.78-3.26) for young adults (n = 46), and 3.09 (95% CI, 2.83-3.35) for adults (n = 29).
  • A linear regression model adjusted for sex and asthma was built that also showed significant adjusted associations (P ≤ .05) between ACE2 expression and age group.
  • Limitations: Did not include individuals older than 60 years. Tissue included was only from the nasal epithelium, and does not reflect ACE2 expression in the pulmonary epithelium (which is under different regulation).
|2020-08-20T12:51:52-04:00May 21st, 2020|COVID-19 Literature|Comments Off on Review: Nasal gene expression of angiotensin-converting enzyme 2 in children and adults

About the Author: Megan McHenry

Megan McHenry
Megan S. McHenry, MD, MS, FAAP is a pediatrician and an Assistant Professor of Pediatrics in the Ryan White Center for Pediatric Infectious Disease and Global Health at Indiana University School of Medicine. Dr. McHenry's research focuses on early childhood development in children living in resource-limited settings. This work is frequently aligned with community-engaged research and dissemination and implementation science frameworks. She primarily conducts research in collaboration with the Academic Model for Providing Access to Healthcare (AMPATH) Research Network in Kenya. Dr. McHenry currently has a career development award through the National Institutes of Health to develop a neurodevelopmental screening program for children born to HIV-infected mothers in Kenya. Dr. McHenry is also the Director of Pediatric Global Health Education and a co-Director of the Morris Green Physician-Scientist Development Program at Indiana University School of Medicine. In additional to global health lectures, she also educates residents and students on early childhood development, basic biostatistical techniques, research methodologies, and research ethics. She mentors multiple pediatric fellows, residents, and medical students interested in early childhood development within global contexts.

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