Transcriptomic Analysis of Coagulation Gene Expression in COVID-19 Patients

The immunopathogenesis of COVID-19 infection is reported to begin with the entry of the SARS-CoV-2 virus into the human body through droplets, entering the lungs, and binding to the ACE-2 receptor. Meanwhile, activated macrophages stimulate an immune and inflammatory response, activating the coagulation cascade. This activation in COVID-19 patients can exacerbate the condition and may result in acute respiratory distress syndrome (ARDS). The coagulation cascade is influenced by the expression of related genes, including F3, F5, F8, F12, F13A1, VWF, THBD, PROC, PROCR, PROS1, SERPINE1, A2M, and PLAUR. This cross-sectional study was conducted in 2022, with 22 mild COVID-19 cases, 35 moderate-to-severe cases, and 20 healthy control individuals from Dr. M. Djamil Padang General Hospital in West Sumatra, Indonesia. Coagulation gene expression data using the RNA-Seq method with transcriptomic analysis were collected and recorded in transcript per-million (TPM) units. The results showed a significant difference in the expression of coagulation genes in moderate-to-severe compared to mild COVID-19 patients and healthy controls. The analysis of log2 folds change has a statistically significant increase observed in the expression of coagulation genes and a significant difference in the expression of coagulation genes among moderate-to-severe and mild patients, as well as healthy controls. The results underscored the impact of COVID-19 infection on the activity of coagulation cascade genes, which could influence the condition of patients and serve as a reference for therapy.