Demographic, clinical and genetic factors associated with COVID-19 disease susceptibility and mortality in a Kurdish population
BACKGROUND: Coronavirus disease 2019 (COVID-19) is a devastating pandemic that causes disease with a variability in susceptibility and mortality based on variants of various clinical and demographic factors, including particular genes among populations. OBJECTIVES: Determine associations of demograp...
Saved in:
| Main Authors: | , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
King Faisal Specialist Hospital and Research Centre
2023-05-01
|
| Series: | Annals of Saudi Medicine |
| Online Access: | http://www.annsaudimed.net/doi/10.5144/0256-4947.2023.125 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1849423030045900800 |
|---|---|
| author | Shukur Wasman Smail Esmaeil Babaei Kawa Amin |
| author_facet | Shukur Wasman Smail Esmaeil Babaei Kawa Amin |
| author_sort | Shukur Wasman Smail |
| collection | DOAJ |
| description | BACKGROUND: Coronavirus disease 2019 (COVID-19) is a devastating pandemic that causes disease with a variability in susceptibility and mortality based on variants of various clinical and demographic factors, including particular genes among populations. OBJECTIVES: Determine associations of demographic, clinical, laboratory, and single nucleotide polymorphisms in the ACE2, TMPRSS2, TNF-α, and IFN-γ genes to the incidence of infection and mortality in COVID-19 patients. DESIGN: Prospective cohort study SETTINGS: Various cities in the Kurdistan Region of Iraq. PATIENTS AND METHODS: This prospective cohort study compared laboratory markers (D-dimer, tumor necrosis factor-alpha [TNF-α], interferon-gamma [IFN-γ], C-reactive protein [CRP], lymphocyte and neutrophil counts) between COVID-19 patients and healthy controls. DNA was extracted from blood, and genotypes were done by Sanger sequencing. MAIN OUTCOME MEASURES: Single nucleotide polymorphisms of the ACE2, TMPRSS2, TNF-α, and IFN-γ genes and demographic characteristics and laboratory markers for predicting mortality in COVID-19. SAMPLE SIZE: 203 (153 COVID-19 patients, 50 health control subjects). RESULTS: Forty-eight (31.4%) of the COVID-19 patients died. Age over 40 and comorbidities were risk factors for mortality, but the strongest associations were with serum IFN-γ, the neutrophil-to-lymphocyte ratio (NLR), and serum TNF-α. The AA genotype and A allele of TMPRSS2 rs2070788 decreased while the GA genotype and A allele of TNF-α increased susceptibility to COVID-19. Patients with the GA genotype of TNF-α rs1800629 had shorter survival times (9.9 days) than those carrying the GG genotype (18.3 days) (P<.0001 by log-rank test). The GA genotype versus the GG genotype was associated with higher levels of serum TNF-α. The GA genotype increased mortality rates by up to 3.8 fold. The survival rate for COVID-19 patients carrying the IFN-γ rs2430561 TT genotype (58.5%) was lower than in patients with the TA and AA genotypes (80.3%). The TT genotype increased the risk of death (HR=3.664, P<.0001) and was linked to high serum IFN-γ production. Olfactory dysfunction was a predictor of survival among COVID-19 patients. CONCLUSIONS: Age older than 40, comorbidities, the NLR and particular genotypes for and the IFN-γ and TNF-α genes were risk factors for death. Larger studies in different populations must be conducted to validate the possible role of particular SNPs as genetic markers for disease severity and mortality in COVID-19 disease. LIMITATIONS: Small sample size. CONFLICT OF INTEREST: None. |
| format | Article |
| id | doaj-art-a6e78ed1dda447f18fcaab5bbcaa698c |
| institution | Kabale University |
| issn | 0256-4947 0975-4466 |
| language | English |
| publishDate | 2023-05-01 |
| publisher | King Faisal Specialist Hospital and Research Centre |
| record_format | Article |
| series | Annals of Saudi Medicine |
| spelling | doaj-art-a6e78ed1dda447f18fcaab5bbcaa698c2025-08-20T03:30:49ZengKing Faisal Specialist Hospital and Research CentreAnnals of Saudi Medicine0256-49470975-44662023-05-0143312514210.5144/0256-4947.2023.125Demographic, clinical and genetic factors associated with COVID-19 disease susceptibility and mortality in a Kurdish populationShukur Wasman Smail0Esmaeil Babaei1Kawa Amin2From the Department of Biology, College of Science, Salahaddin University-Erbil, IraqFrom the Department of Biology, School of Natural Sciences, University of Tabriz, Tabriz, IranFrom the College of Medicine, University of Sulaimani, Sulaymaniyah, IraqBACKGROUND: Coronavirus disease 2019 (COVID-19) is a devastating pandemic that causes disease with a variability in susceptibility and mortality based on variants of various clinical and demographic factors, including particular genes among populations. OBJECTIVES: Determine associations of demographic, clinical, laboratory, and single nucleotide polymorphisms in the ACE2, TMPRSS2, TNF-α, and IFN-γ genes to the incidence of infection and mortality in COVID-19 patients. DESIGN: Prospective cohort study SETTINGS: Various cities in the Kurdistan Region of Iraq. PATIENTS AND METHODS: This prospective cohort study compared laboratory markers (D-dimer, tumor necrosis factor-alpha [TNF-α], interferon-gamma [IFN-γ], C-reactive protein [CRP], lymphocyte and neutrophil counts) between COVID-19 patients and healthy controls. DNA was extracted from blood, and genotypes were done by Sanger sequencing. MAIN OUTCOME MEASURES: Single nucleotide polymorphisms of the ACE2, TMPRSS2, TNF-α, and IFN-γ genes and demographic characteristics and laboratory markers for predicting mortality in COVID-19. SAMPLE SIZE: 203 (153 COVID-19 patients, 50 health control subjects). RESULTS: Forty-eight (31.4%) of the COVID-19 patients died. Age over 40 and comorbidities were risk factors for mortality, but the strongest associations were with serum IFN-γ, the neutrophil-to-lymphocyte ratio (NLR), and serum TNF-α. The AA genotype and A allele of TMPRSS2 rs2070788 decreased while the GA genotype and A allele of TNF-α increased susceptibility to COVID-19. Patients with the GA genotype of TNF-α rs1800629 had shorter survival times (9.9 days) than those carrying the GG genotype (18.3 days) (P<.0001 by log-rank test). The GA genotype versus the GG genotype was associated with higher levels of serum TNF-α. The GA genotype increased mortality rates by up to 3.8 fold. The survival rate for COVID-19 patients carrying the IFN-γ rs2430561 TT genotype (58.5%) was lower than in patients with the TA and AA genotypes (80.3%). The TT genotype increased the risk of death (HR=3.664, P<.0001) and was linked to high serum IFN-γ production. Olfactory dysfunction was a predictor of survival among COVID-19 patients. CONCLUSIONS: Age older than 40, comorbidities, the NLR and particular genotypes for and the IFN-γ and TNF-α genes were risk factors for death. Larger studies in different populations must be conducted to validate the possible role of particular SNPs as genetic markers for disease severity and mortality in COVID-19 disease. LIMITATIONS: Small sample size. CONFLICT OF INTEREST: None.http://www.annsaudimed.net/doi/10.5144/0256-4947.2023.125 |
| spellingShingle | Shukur Wasman Smail Esmaeil Babaei Kawa Amin Demographic, clinical and genetic factors associated with COVID-19 disease susceptibility and mortality in a Kurdish population Annals of Saudi Medicine |
| title | Demographic, clinical and genetic factors associated with COVID-19 disease susceptibility and mortality in a Kurdish population |
| title_full | Demographic, clinical and genetic factors associated with COVID-19 disease susceptibility and mortality in a Kurdish population |
| title_fullStr | Demographic, clinical and genetic factors associated with COVID-19 disease susceptibility and mortality in a Kurdish population |
| title_full_unstemmed | Demographic, clinical and genetic factors associated with COVID-19 disease susceptibility and mortality in a Kurdish population |
| title_short | Demographic, clinical and genetic factors associated with COVID-19 disease susceptibility and mortality in a Kurdish population |
| title_sort | demographic clinical and genetic factors associated with covid 19 disease susceptibility and mortality in a kurdish population |
| url | http://www.annsaudimed.net/doi/10.5144/0256-4947.2023.125 |
| work_keys_str_mv | AT shukurwasmansmail demographicclinicalandgeneticfactorsassociatedwithcovid19diseasesusceptibilityandmortalityinakurdishpopulation AT esmaeilbabaei demographicclinicalandgeneticfactorsassociatedwithcovid19diseasesusceptibilityandmortalityinakurdishpopulation AT kawaamin demographicclinicalandgeneticfactorsassociatedwithcovid19diseasesusceptibilityandmortalityinakurdishpopulation |