The effect of polymorphic markers of genes of proteins involved in the folate metabolism on the course and outcomes of the viral lung damage associated with SARS-CoV-2 infection

Introduction. Infection with human coronavirus 2 (SARS-CoV-2) associated with severe acute respiratory syndrome, forms polymorphous pattern of the infectious disease (COVID-19) in the range from mild acute respiratory infection to severe and life-threatening variations of systemic infection with respiratory tract involvement. Among significant predictors of the severe course and lethal outcome in the individuals with lung affection associated with COVID-19 infection, the increase of plasma levels of D-dimer, homocysteine, and some single-nucleotide polymorphisms (SNPs) of genes of the folate cycle proteins are singled out.
Aim. To assess the role of genetic markers of folic acid metabolic disorders in the development of symptoms and the outcomes of viral lung damage associated with SARS-CoV-2 infection in the hospitalized patients.
Materials and methods. In an open prospective comparative study the assessment of outcomes depending on polymorphic markers of protein genes of the folate cycle and the use of fixed combination of folic acid and vitamins В₆, В₁₂ in comprehensive therapy was performed in 117 patients with lung damage associated with SARS-CoV-2 infection.
Results. Patients showed an increased relative risk of the heterozygous minor G-allele carriage of 66AG SNP of the methionine synthase reductase gene (MTRR). The homozygous MTRR G66G genotype was associated with indicators of anemia and thrombocytopenia. A statistically significant decrease in the odds ratio in achieving negative results for SARSCoV-2 RNA detection by the 14th day of therapy in patients with the heterozygous 677CT genotype and the homozygous 677TT genotype of the MTHFR (methylenetetrahydrofalate reductase) gene was established.
Conclusion. Lung damage caused by SARS-CoV-2 infection is associated with an increased risk of genetic metabolic disorder of folate and vitamin B_12.

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