Association of the -31*C Proinflammatory Allele with the Severity of COVID-19 Patients: A Preliminary Report.

Individuals with no known comorbidities or risk factors may develop severe coronavirus disease 2019 (COVID-19). The present study assessed the effect of certain host polymorphisms and viral lineage on the severity of COVID-19 among hospitalized patients with no known comorbidities in Mexico. The analysis included 117 unrelated hospitalized patients with COVID-19. Patients were stratified by whether they required intensive care unit (ICU) admission: the ICU group ( = 40) and non-ICU group ( = 77). COVID-19 was diagnosed on the basis of a positive severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) reverse transcription-polymerase chain reaction (RT-PCR) assay and clinical and radiographic criteria. The presence of the (T/C) polymorphism was determined for all patients using PCR and nucleotide sequencing. Genotyping of the (-590, T/C) and (-251, T/A) polymorphisms was performed by the amplification refractory mutation system-PCR method. Genotyping of was performed using PCR. Viral genome sequencing was performed using the ARTIC Network amplicon sequencing protocol using a MinION. Logistic regression analysis identified the carriage of *C as an independent potential risk factor (odds ratio [OR] = 3.1736, 95% confidence interval [CI] = 1.0748-9.3705,  = 0.0366) for ICU admission and the presence of *2 as a protective factor (OR = 0.4371, 95% CI = 0.1935-0.9871,  = 0.0465) against ICU admission. Under the codominant model, the CC genotype of -31 significantly increased the risk of ICU admission (OR: 6.38, 95% CI: 11.57-25.86,  < 0.024). The -31 *C--590 *T haplotype increased the risk of ICU admission (OR = 2.53, 95% CI = 1.02-6.25,  = 0.047). The 42 SARS-CoV-2 genomes sequenced belonged to four clades, 20A-20D. No association was detected between SARS-CoV-2 clades and ICU admission or death. Thus, in patients with no known comorbidities or risk factors, the -31*C proinflammatory allele was observed to be associated with the risk of ICU admission owing to COVID-19.