Association of TNF-alpha G-308 a Promoter Polymorphism with the Course and Outcome of COVID-19 Patients

Background: Tumor necrosis factor-alpha (TNF-alpha) is one of the most important cytokines that manage the host defense mechanism, which may play a role in the pathogenesis of COVID-19 patients. The work aims to study the association of TNF-alpha G-308 A gene polymorphism with the course and outcome of COVID-19 patients in Mansoura University Hospital. Methods: 900 patients with COVID-19 infection and 184 controls were tested for TNF-alpha G-308 A promoter polymorphism. Different genotypes of TNF-alpha G-308 A were compared as regards the severity and prognosis of the disease. Results: No statistically significant difference was found between patients and controls as regards the demographic data. The AA genotype of TNF-alpha showed a higher incidence of the disease in comparison to the other genotypes. As regards the demographic and laboratory characters, no statistically significant difference was found between the different genotypes except for age, lymphopenia, CRP, and serum ferritin levels. In 336(80.0%) cases of the AA genotype, the disease was severe in comparison to 90(41.7%) cases in the GA genotype and no cases in the GG genotype with P = .001. Conclusion: People who carry the A allele of TNF-alpha polymorphism are more prone to COVID-19 infection. The AA genotype of TNF-alpha is associated with a more aggressive pattern of the disease. In those patients, the use of anti - TNF therapy may be promising.