الفهرس 
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Abstract
COVID-19, caused by SARS-CoV-2, was a global pandemic resultingin over 772 million confirmed cases and 6.9 million deaths worldwide.Symptoms can range from asymptomatic to severe pneumonia, withcomorbidities potentially causing intensive care and mechanical ventilation,leading to opportunistic and hospital-acquired infections.Symptoms of COVID-19 can vary due to various factors, includinghealth conditions, age, and sex. Lung viral infection can weaken the immunesystem, leading to alterations in respiratory microbiota. Bacterial coinfectionscomplicate viral respiratory infections and are associated with seriousoutcomes. In past pandemics, bacterial coinfections were a major cause ofmortality, with prevalence ranging from 12.4 to 50%.Past seasonal flu and influenza pandemics suggest that bacterialcoinfections can worsen viral diseases. In severe cases, immunedysregulation may predispose patients to coinfection, which was diagnosed inalmost 50% of COVID-19 patients who died.ACE gene polymorphism, involving the insertion or deletion of a287-bp Alu repeat sequence, is linked to circulating and tissue ACE levels,with the D allele exhibiting higher activity. This suggests ACE genepolymorphism may be crucial in COVID-19 patients prone to severe lunginjury.The aim of the present study was to explore the prognostic value ofAngiotensin I Converting Enzyme gene polymorphism in streptococcuspneumonia coinfection in COVID19 patients.