| Summary: | Abstract Background ACE1 I/D rs1799752 and ACE2 rs2285666 genetic polymorphisms could play a critical role in altering the clinical outcomes of SARS‐CoV‐2. The findings of previous studies remained inconclusive. This meta‐analysis was performed to evaluate the association and provide a more reliable outcome. Methods This study was completed following the updated recommendations of PRISMA using RevMan 5.4.1 statistical software. Results A total of 11 studies with 950 severe cases and 1573 non‐severe cases with COVID‐19 infection were included. Pooled analysis showed that ACE1 I/D polymorphism was correlated with the severity of SARS‐CoV‐2 in the DD genotype and D allele for the fixed‐effects model (OR:1.27 and OR:1.17). Besides, codominant 3, recessive, and allele models were associated with the severity of the fixed‐effects model (OR:1.35, OR:1.37, and OR:1.20) in Caucasian ethnicity. ACE2 rs2285666 was linked with the severity in codominant 3 (OR:2.63, for both random‐ and fixed effects‐models), overdominant (OR:1.97, for random‐effects model and OR:1.97, for fixed effects‐model), and recessive model (OR:0.41 for fixed‐ and random‐effects model). Allele model of rs2285666 showed a significant association in the fixed‐effects model (OR:1.61). Conclusion Our present meta‐analysis suggests that ACE1 I/D rs1799752 and ACE2 rs2285666 variants may enhance the severity in SARS‐CoV‐2 infected patients. Future studies are warranted to verify our findings.
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