Expression Profile of SARS-CoV-2 Entry Receptor ACE2 in the Hepatocellular Carcinoma and its Impact on COVID-19 Patients

Abstract: The SARS-CoV-2 infection leads to liver injury and promotes other viral infections such as hepatitis B virus (HBV) in COVID-19 patients. Obesity is involved with an increased risk of mortality in hepatocellular carcinoma (HCC) patients. In the current study, we analyzed the SARS-CoV-2 entry receptor ACE2 expression patterns in various HCC patients using different public databases on cancer. We found that the ACE2 and TMPRSS2 mRNA expressions are significantly downregulated in HCC tissues compared with the healthy population. Interestingly, high ACE2 expression is positively associated with HCC patient’s obesity and age of 61 to 80 years old. A significantly lower survivability rate is revealed in extremely obese and obese HCC patients with high expression of ACE2. In addition, the expression of important innate immune-related genes such as IKBKB, MAVS, IRF3, and RELA are found to be significantly increased in HCC patients. Therefore, it might be suggested that obesity and age of the HCC patient along with the involvement of innate immune genes, might be the important triggers for COVID-19 pathogenesis.