Abstract
Intriduction: The acute respiratory disease COVID-19 continues to pose a threat to human health worldwide. Identifying new predictors of severe coronavirus disease is necessary to prevent new outbreaks and reduce mortality among the population.
 The aim of the study was to analyze the prevalence and impact of the angiotensin II type 1 receptor polymorphism (A1166C at1r) on the severity of COVID-19.
 Materials and methods: We conducted a case-control study involving 151 patients who were diagnosed with COVID-19 and were inpatients at the Municipal Clinical Institution "POKIL" of the OR and the Municipal Clinical Institution "3rd City Hospital of the OR" from April 2020 to March 2021. The diagnosis was made based on the examination of patients by polymerase chain reaction (PCR) and the detection of SARS-CoV-2 virus RNA in the nasopharyngeal scrapings. One of the three genotypes of the at1r gene (rs5186) was identified in each of the patients: AA, AC, and CC. The distribution of genotypes was as follows: AA - 58 people (38.4%), AC - 70 (46.4%), CC - 23 (15.2%).
 The group of healthy individuals had the following genotype distribution: AA - 42 people (51.2%), AC - 28 people (34.1%) and SS - 12 people (14.7%). In order to determine the impact of the at1r gene polymorphism on the course of COVID-19, patients (n=151) were divided into 2 groups depending on the carriage of the C allele.
 Results: The combined AS+CC genotype was significantly more common in the group with severe (p=0.011) and severe + critical (p=0.003) course compared to the control group. Patients with combined AC+CC genotype were significantly more likely to be hospitalized with moderate (p=0.016) and severe and critical disease (p=0.016). Patients with the combined AC+CC genotype were significantly more likely to require oxygen therapy (67.7%) compared to patients with the AA genotype (44.8%), p=0.005. They were more likely to be supported with a face mask - 49 (52.7%).
 Conclusions: the angiotensin II type 1 receptor polymorphism (A1166C at1r) is a factor influencing the severity of COVID-19. Patients with a combined AC+CC genotype are significantly more likely to have a severe course of the disease and require oxygen support.
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