Some people infected with develop severe cases of COVID-19, while others are asymptomatic. The reason for this difference in disease severity is unknown, although genetic and environmental factors probably play a role.

Felipe Diaz-Griffero, Ph.D., and colleagues suspected that differences in ACE2—the cell-surface receptor to which the virus must bind to cause infection—might influence COVID-19 severity. In a study published online on June 30 in Viruses, they studied whether the virus’s ability to bind to ACE2 variants from different populations corelated with greater or lesser mortality from SARS-CoV-2 infection in those populations. Using a cell culture system, Dr. Diaz-Griffero and colleagues found that ACE2 variants that resisted SARS-CoV-2 infection occurred almost exclusively in Asian populations, which in general have lower COVID-19 mortality rates compared with other populations. The researchers concluded that variations in the structure of ACE2 may influence host susceptibility to SARS-CoV-2 and partially account for the differences in COVID-19 severity among different ethnic groups. The findings could lead to novel strategies for preventing and treating viral infections.  

Dr. Diaz-Griffero is professor of microbiology & immunology and Elsie Wachtel Faculty Scholar at Einstein.