Affiliation:
1. Department of Otolaryngology—Head and Neck Surgery Johns Hopkins University School of Medicine Baltimore Maryland USA
2. Department of Anesthesiology and Critical Care Medicine Johns Hopkins University School of Medicine Baltimore Maryland USA
3. Department of Biomedical Engineering Johns Hopkins University School of Medicine Baltimore Maryland USA
Abstract
AbstractObjectiveTo investigate differences in angiotensin‐converting‐enzyme‐2 (ACE2) and bitter taste receptor (TAS2R38) expression between patient age groups and comorbidities to characterize the pathophysiology of coronavirus 19(COVID‐19) pandemic. ACE2 is the receptor implicated to facilitate SARS‐CoV‐2 infections and levels of expression may correlate to the severity of COVID‐19 infection. TAS2R38 has many non‐gustatory roles in disease, with some evidence of severe COVID‐19 disease in certain receptor phenotypes.MethodsWe conducted a prospective cohort study and collected nasal and lingual tissue from healthy pediatric (n = 22) and adult (n = 25) patients undergoing general anesthesia for elective procedures. RNA isolation and qPCR were performed with primers targeting ACE2 and TAS2R38.ResultsA total of 25 adult (52% male; 44% obese) and 22 pediatric (50% male; 36% obese) patients were enrolled, pediatric tissue had 43% more nasal ACE2 RNA expression than adults with a median fold change of 0.69 (IQR 0.37, 0.98) in adults and 0.99 (IQR 0.74, 1.43) in children (p < .05). There were no differences between the age groups in ACE2 expression of lingual tissue (p = .14) or TAS2R38 expression collected from either nasal (p = 049) or lingual tissue (p = .49). Stratifying for obesity yielded similar differences between nasal ACE2 expression between adults and children with median fold change of 0.56 (IQR 0.32, 0.87) in adults and 1.0 (IQR 0.82, 1.52) in children (p < .05).ConclusionsACE2 receptor expression is higher in nasal tissue collected from children compared to adults, suggesting COVID‐19 infectivity is more complicated than ACE2 and TAS2R38 mRNA expression.Level of EvidenceNA.