Amodio Emanuele, Pipitone Rosaria Maria, Grimaudo Stefania, Immordino Palmira, Maida Carmelo Massimo, Prestileo Tullio, Restivo Vincenzo, Tramuto Fabio, Vitale Francesco, Craxì Antonio, Casuccio Alessandra
Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties, University of Palermo, 90127 Palermo, Italy.
Department of Medicine, ARNAS Civico, Unità Operativa Malattie Infettive, 90127 Palermo, Italy.
J Clin Med. 2020 Oct 15;9(10):3315. doi: 10.3390/jcm9103315.
The course of SARS-CoV-2 infection ranges from asymptomatic to a multiorgan disease. In this observational study, we investigated SARS-CoV-2 infected subjects with defined outcomes, evaluating the relationship between viral load and single nucleotide polymorphisms of genes codifying for IFNλs (interferon). The study enrolled 381 patients with laboratory-confirmed SARS-CoV-2 infection. For each patient, a standardized form was filled including sociodemographic variables and clinical outcomes. The host's gene polymorphisms (IFNL3 rs1297860 C/T and INFL4 rs368234815 TT/ΔG) and RtReal-Time PCR cycle threshold (PCR Ct) value on SARS-CoV-2 were assessed on nasal, pharyngeal or nasopharyngeal swabs. Higher viral loads were found in patients aged > 74 years and homozygous mutant polymorphisms DG in IFNL4 (adj-OR = 1.16, 95% CI = 1.01-1.34 and adj-OR = 1.24, 95% CI = 1.09-1.40, respectively). After adjusting for age and sex, a statistically significantly lower risk of hospitalization was observed in subjects with higher RtReal-Time PCR cycle threshold values (adj-OR = 0.95, 95% CI = 0.91, 0.99; = 0.028). Our data support the correlation between SARS-CoV-2 load and disease severity, and suggest that IFNλ polymorphisms could affect the ability of the host to modulate viral infection without a clear impact on the outcome of COVID-19.
新型冠状病毒2型（SARS-CoV-2）感染的病程范围从无症状到多器官疾病。在这项观察性研究中，我们调查了具有明确结局的SARS-CoV-2感染受试者，评估病毒载量与编码干扰素λ（IFNλs）基因的单核苷酸多态性之间的关系。该研究纳入了381例实验室确诊的SARS-CoV-2感染患者。为每位患者填写了一份标准化表格，包括社会人口统计学变量和临床结局。在鼻拭子、咽拭子或鼻咽拭子上评估宿主的基因多态性（IFNL3 rs1297860 C/T和INFL4 rs368234815 TT/ΔG）以及SARS-CoV-2的逆转录实时荧光定量PCR循环阈值（PCR Ct）值。在年龄>74岁且IFNL4基因纯合突变多态性为DG的患者中发现了更高的病毒载量（校正比值比分别为1.16，95%置信区间为1.01-1.34和1.24，95%置信区间为1.09-1.40）。在调整年龄和性别后，观察到逆转录实时荧光定量PCR循环阈值较高的受试者住院风险在统计学上显著降低（校正比值比=0.95，95%置信区间为0.91，0.99；P=0.028）。我们的数据支持SARS-CoV-2载量与疾病严重程度之间的相关性，并表明IFNλ多态性可能影响宿主调节病毒感染的能力，但对2019冠状病毒病（COVID-19）的结局没有明显影响。
