Mendelian randomization analysis provides causality of smoking on the expression of ACE2, a putative SARS-CoV-2 receptor

  1. Hui Liu
  2. Junyi Xin
  3. Sheng Cai
  4. Xia Jiang  Is a corresponding author
  1. Zhejiang University, China
  2. Nanjing Medical University, China
  3. Karolinska Institutet, Sweden

Abstract

Background: To understand a causal role of modifiable lifestyle factors in ACE2 expression (a putative SARS-CoV-2 receptor) across 44 human tissues/organs, and in COVID-19 susceptibility and severity, we conducted a phenome-wide two-sample Mendelian randomization (MR) study.

Methods: More than 500 genetic variants were used as instrumental variables to predict smoking and alcohol consumption. Inverse-variance weighted approach was adopted as the primary method to estimate a causal association, while MR-Egger regression, weighted median and MR-PRESSO were performed to identify potential horizontal pleiotropy.

Results: We found that genetically predicted smoking intensity significantly increased ACE2 expression in thyroid (β=1.468, p=1.8 10-8); and increased ACE2 expression in adipose, brain, colon and liver with nominal significance. Additionally, genetically predicted smoking initiation significantly increased the risk of COVID-19 onset (odds ratio=1.14, p=8.7 10-5). No statistically significant result was observed for alcohol consumption.

Conclusions: Our work demonstrates an important role of smoking, measured by both status and intensity, in the susceptibility to COVID-19.

Funding: Dr. Jiang is supported by research grants from the Swedish Research Council (VR-2018-02247) and Swedish Research Council for Health, Working Life and Welfare (FORTE-2020-00884).

Data availability

Data and main programming codes with annotations have been uploaded to GitHub and made publicly available at https://github.com/hye-hz/MR_Smoke_COVID19.git.

The following previously published data sets were used

Article and author information

Author details

  1. Hui Liu

    Zhejiang Provincial Key Laboratory of Laparoscopic Technology, Zhejiang University, Hangzhou, China
    Competing interests
    The authors declare that no competing interests exist.
    ORCID icon "This ORCID iD identifies the author of this article:" 0000-0002-5531-3640
  2. Junyi Xin

    Department of Environmental Genomics, Nanjing Medical University, Nanjing, China
    Competing interests
    The authors declare that no competing interests exist.
    ORCID icon "This ORCID iD identifies the author of this article:" 0000-0001-6677-3936
  3. Sheng Cai

    Institute of Drug Metabolism and Pharmaceutical Analysis, Zhejiang University, Hangzhou, China
    Competing interests
    The authors declare that no competing interests exist.
  4. Xia Jiang

    Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
    For correspondence
    xia.jiang@ki.se
    Competing interests
    The authors declare that no competing interests exist.
    ORCID icon "This ORCID iD identifies the author of this article:" 0000-0001-5878-8986

Funding

Swedish Research Council (VR-2018-02247)

  • Xia Jiang

Swedish Research Council for Health, Working Life and Welfare (FORTE-2020-00884)

  • Xia Jiang

The funders had no role in study design, data collection and interpretation, or the decision to submit the work for publication.

Copyright

© 2021, Liu et al.

This article is distributed under the terms of the Creative Commons Attribution License permitting unrestricted use and redistribution provided that the original author and source are credited.

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  1. Hui Liu
  2. Junyi Xin
  3. Sheng Cai
  4. Xia Jiang
(2021)
Mendelian randomization analysis provides causality of smoking on the expression of ACE2, a putative SARS-CoV-2 receptor
eLife 10:e64188.
https://doi.org/10.7554/eLife.64188

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https://doi.org/10.7554/eLife.64188

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