TMPRSS2 rs2070788 and rs383510 polymorphisms and laboratory markers as predictors for severity and mortality among COVID-19 patients: A single center study

Background: The COVID-19 pandemic caused a worldwide health crisis and put healthcare systems on the verge of collapse. We aimed to investigate whether genetic variations in the TMPRSS2 gene namely rs2070788 and rs383510, along with other relevant indicators, can predict the severity of COVID-19 outcomes. Mehods: This study included 100 COVID-19 patients confirmed by PCR between June to December 2021. Fifty patients were classified as severe COVID-19 cases, while the remaining had mild symptoms. Two specific single nucleotide polymorphisms (SNPs) within the TMPRSS2 gene were analyzed using real-time PCR. Demographic data, laboratory tests, and clinical symptoms were gathered. Results: The study revealed a high prevalence of the TMPRSS2 rs383510 CC genotype and C allele among COVID-19 patients, particularly in those with severe presentation (P=0.029). Also, that genotype and allele was dominated among severe patients who developed complications or did not survive. For rs2070788, the A allele was more common in patients with severe complications or non-survivors. Cut-off for IL-6 ≥ 62.0 pg/mL and ≥85.0 pg/mL respectively exhibited the highest specificity and positive predictive value for predicting progression to complications and mortality. Conclusion: We found a significant association between the TMPRSS2 rs383510 CC genotype and C allele and severe COVID-19 cases (P=0.029). This finding adds to the growing body of evidence suggesting a role for TMPRSS2 genetic variations in determining COVID-19 severity. Additionally, the study demonstrated a correlation between elevated levels of inflammatory markers (CRP, ferritin, and IL-6) and the progression to critical illness in COVID-19 patients.