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

BackgroundAngiotensin converting enzyme 2 (ACE2) protein serves as the host receptor for SARS-CoV-2, with a critical role in viral infection. We aim to understand population level variation of nasopharyngeal ACE2 transcription people tested COVID-19 and relationship between SARS-CoV-2 load, while adjusting expression of: (i) complementary protease, Transmembrane serine protease (TMPRSS2), (ii) soluble ACE2, (iii) age, (iv) biological sex. The gene was targeted measure transmembrane transcripts.MethodsA cross-sectional study n = 424 “participants” aged 1–104 years referred testing performed British Columbia, Canada. Patients who positive were matched by age sex patients negative. Viral load assessed quantitative reverse-transcriptase polymerase chain reaction. Bivariate analysis multiple linear regression infection.FindingsAnalysis showed no association those negative (P 0•092). Mean relative 0•00012) (P<0•0001) isoforms, well TMPRSS2 higher COVID-19-negative participants than COVID--19 ones, yielding correlation diagnosis. In bivariate COVID-19-positive participants, positively correlated RNA (B 0•49, R2=0•14, P<0•0001), negatively (B= -0•85, R2= 0•26, found -0•042, R2=<0•10, P 0•69). Multivariable that greatest loads observed high (?= 0•89, 95%CI: [0•59 1•18]), isoform appears protect against upper respiratory tract -0•099, [-0•18 -0•022]).InterpretationNasopharyngeal plays dual, contrasting infection tract. Transcription correlates, correlates after sex, TMPRSS2.FundingThis project (COV-55) funded Genome Columbia part their rapid response initiative.