Investigation of prothrombin G20210A (factor 2) and PAI-1-4G/5G gene polymorphism in patients with covid-19 infection presenting to emergency department

Considering the results observed among COVID-19 populations, there is a suggestion that there may be a genetic predisposition to complications of thromboembolism triggered by COVID-19 pneumonia in patients carrying mutations in interacting factors. In our study, we aim to examine the relationship between the severity of COVID-19 and Prothrombin G20210A (Factor 2) and PAI-1-4G/5G gene polymorphisms and the clinical course of this relationship. Patients who presented at Pamukkale University Faculty of Medicine Department of Emergency Medicine with complaints such as cough, sputum, fever, and shortness of breath and were subsequently diagnosed with COVID-19 in the emergency department (n = 150) were included in the study, along with 300 healthy individuals who did not report any infection-related symptoms. In addition to collecting blood samples from the patients for laboratory analysis, genetic haplotyping was conducted using blood from anticoagulant tubes. Prothrombin G20210A and PAI-1 gene mutations were examined in both the patient and control groups, and the findings were recorded and reported. Our patients were between the ages of 18-90 and had a mean age of 53.4. 42% of these patients were female, and no significant differences were found between the genomes and polymorphisms examined. Prothrombin G20210A and PAI-1 gene polymorphisms were significant between the patient and control groups. The most common symptoms in patients were: cough (46%), shortness of breath (37.3%), fever (24.7%), and fatigue (18%). No significant difference was observed between Prothrombin G20210A GA and GG alleles in the clinical and laboratory findings of the patients. However, there was a significant difference between Monocyte and Urea 4G/5G PAI-1 gene polymorphisms in the laboratory findings of the patients. A significant relationship was found between PAI-1 gene polymorphism and CURB-65 score, PSI score, length of stay, imaging results, place of hospitalization, and mortality. As a result, we have found that PAI-1 gene polymorphisms play a significant role in COVID-19 diagnosis, guiding hospital admissions, predicting mortality, and determining PSI scores. We believe that PAI-1 gene mutations may have a direct relationship with monocyte counts and can serve as an important marker for patients with suspected COVID-19, as well as for assessing the risk of VTE. Additionally, individuals with the PAI-1 4G/5G heterozygous genotype upon admission to the emergency department exhibited a higher average CURB-65 score of 1.56 and a similar rate of admission to the intensive care unit. Key Words: COVİD-19, Thromboembolism, Prothrombin G20210A, PAI-1, Gene Mutation