COVID-19 Seyri ile Endotelyal Nitrik Oksit Sentaz (eNOS) Genetik Polimorfizmlerinin İlişkisi

Abstract

The World Health Organization has identified Coronavirus Disease 2019 (COVID-19) as an epidemic of acute severe respiratory syndrome coronavirus-2 (SARS-CoV-2) infection. Due to the spread and severity of the virus, it was defined as a global epidemic (pandemic) on March 11, 2020. It has been observed that the course of COVID-19 infection may differ individually between patients, and studies that can explain these differences are needed. In this study, it is aimed to examine the relationship between the course of an infectious agent, COVID-19, and eNOS genetic polymorphisms. Patients who applied to the Pulmonology outpatient clinic between 01.12.2021 and 01.09.2022 for any reason, over the age of 18 and had COVID-19 before January 2021 were included in our study. According to the World Health Organization and the Ministry of Health's COVID-19 criteria, they were classified as mild or severe disease based on the clinical history provided by the patients. Mild patients were divided into group 1, severe patients were divided into group 2. After the polyclinic examination, blood was taken from the volunteers participating in the study in an EDTA tube in addition to the requested blood tests, and then DNA isolation and then genotyping were performed. Genotyping experiments of NOS3 G894T (rs1799983) and NOS3 VNTR 4a/4b (rs61722009) were carried out using polymerase chain reaction (PCR) and restriction fragment length polymorphism (RFLP) methods. A total of 180 patients were included in the study, 107 of whom were group 1 mild and 73 group 2 severe patients. G/G genotype, which is NOS3 G894T wild type, was observed in 55 (51.4%) patients in group 1 mild patients, and 40 (54.8%) individuals in group 2 severe patients. Heterozygous G/T genotype was observed in 38 (35.3%) individuals in group 1 mild, and 23 (31.5%) in group 2 severe patients. Polymorphic T/T genotype was observed in 14 (13.1%) individuals in group 1 and in 10 (13.7%) individuals in group 2. When the NOS3 VNTR 4a/4b genotypes were examined, the 4c allele, which was reported to be rare in the literature, was detected in 2 patients in group 2, and the presence of asthma was noted in both of these patients. Of 107 patients in Group 1, 3 (2.8%) 4a/4a, 25 (23.4%) 4a/4b, 79 (73.8%) 4b/4b genotypes were detected. While 4a/4a genotype was not detected in any of the 71 patients in Group 2, 4a/4b genotypes were found in 15 (21.1%) and 4b/4b genotypes in 56 (78.9%) patients. There was no statistically significant difference in terms of genotype frequency in the study groups, and an increasing trend was observed in the 4b/4b genotype in the severely affected patient group (p=0,193). Our study detected no significant association between the NOS3 G894T and NOS3 VNTR 4a/4b genetic polymorphisms and the course of COVID-19. Presence of coronary arterial disease, diabetes, cardiac arrhythmia and COPD, and advanced age were seen as risk factors for the development of oxygen demand and hospitalization in COVID-19 patients.