Dados do Trabalho

Título

ACE/ACE2 genes and FUT2 secretory status susceptibility of children with SARS-CoV-2 with acute gastroenteritis and respiratory infection.

Introdução

Brazil has faced one of the highest pediatric COVID-19 mortality rates during the pandemic. COVID-19 is characterized by symptoms such as high fever, cough, and difficulty breathing, but gastrointestinal symptoms like diarrhea can also occur. Acute gastroenteritis (AGE) is the second leading cause of morbidity and mortality in children under five and has been associated with COVID-19, although less frequently than respiratory symptoms. SARS-CoV-2 reaches the gastrointestinal tract via ACE2 receptors in the small intestine, making gastrointestinal symptoms a key diagnostic indicator, especially in patients without respiratory signs. Host genetic factors, including polymorphisms in ACE and ACE2 genes, and histo-blood group antigens (HBGA), may alter susceptibility to SARS-CoV-2 infection.

Objetivo (s)

This study is an epidemiological survey with children ≤3 years of age living in the Northwest Amazon region (NWAR), where the frequency of SARS-CoV-2 and the presence of polymorphisms in the ACE I/D and ACE2 G8780A28 genes were investigated. The profile of HBGA (secretory/non-secretory and Lewis), as a genetic susceptibility factor, was also verified.

Material e Métodos

This project was approved by the Research Ethics Committee of the Children's Hospital of Boa Vista/Plataforma Brasil under number 133480 on 23/11/2015. Fecal and saliva samples were collected from 202 children (n=404) and subjected to SARS-CoV-2 detection by RT-qPCR. Polymorphisms in the angiotensin-converting enzyme (ACE rs4646994) and ACE2 (G8780A; rs2285666) genes were detected by real-time PCR with SYBR GREEN and PCR/Alul digestion, respectively. The secretor and Lewis status of histo-blood group antigens (HBGA) was determined by phenotyping/ELISA.

Resultados e Conclusão

Children from the Northwestern Amazon region exhibited similar frequencies of AGE and ARI, with 59.9% being boys. Fever (>38.5°C) was common in both conditions, while AGE was more associated with vomiting and mucus in feces, and ARI with coughing and pneumonia. ACE I/I genotype predominated among children, and no significant associations were found between ACE/ACE2 polymorphisms and clinical symptoms, except for males with the ACE2 G8780A variant who were more susceptible to ARI. The SARS-CoV-2 positivity rate was 6%, with all positive children being secretors. The study, despite its limitations, provides critical insights into the genetic and clinical characteristics of children in the Amazon, aiding public health strategies.

Palavras Chave

SARS-CoV-2; acute diarrheal disease; SNP