A Meta-Analysis of the Association between Apolipoprotein E Polymorphisms and SARS-COV-2 Risk/Severity in the Korean Population

Abstract: Coronavirus disease 2019 (COVID-19) has spread since 2019, posing a massive burden on human health and socioeconomics. While clinical characteristics such as age, sex, and comorbidities cannot fully explain the heterogeneity of COVID-19 susceptibility and prognosis, recent studies suggest that genetic factors may contribute to these discrepancies. Apolipoprotein E (APOE) constitutes a determinant of several diseases, including neurodegenerative diseases, cardiovascular diseases, and viral infections. Current evidence reveals that APOE genotypes are associated with COVID-19 susceptibility and severity. This study examines the association of APOE genotypes with the risk and severity of COVID-19 in Koreans. Furthermore, we conducted a meta-analysis using published and preprint databases to extend the studied populationfollowing PRISMA guidelines. In the Korean population, we did not find any associations of APOE genotypes with COVID-19 susceptibility or severity. However, meta-analysis demonstrated elevated risk of COVID-19 susceptibility and accelerated prognosis in individuals carrying the APOEε4 allele compared to individuals carrying other APOE alleles,with odds ratio (OR) = 1.29, 95% confident interval (CI): 1.04–1.59, and OR = 1.67, 95% CI: 1.18–2.35 respectively. Further work is required to understand the relationship between other factors and APOE genotypes in COVID-19 infection, as well as the clinical implication of APOE genotyping in personalized treatment.