Study of Hepcidin Gene Polymorphisms in Patients with COVID-19-Associated Mucormycosis

Abstract

Following the coronavirus disease 2019 outbreak (COVID-19), it became a worrisome health burden worldwide. COVID-19-associated mucormycosis emergence, characterized by dysregulated inflammation and iron metabolism, exacerbated the prognosis of affected patients. Given the significance of هپسیدین in regulating inflammation and iron metabolism, this study investigated the significance of hepcidin single nucleotide polymorphisms (SNP) in COVID-19-associated mucormycosis development, along with the association between the clinical and laboratory factors and COVID-19-associated mucormycosis.

Materials and methods: In this cross-sectional study, 110 patients with COVID-19 who had a history of hospitalization due to this disease in Sina and Imam Reza hospitals of Tabriz University of Medical Sciences in the summer of 1400 were included in the study. 50 patients had mucormycosis infection and 60 patients did not have it and were included in the study as a control group. Their medical records and laboratory results were reviewed. Peripheral blood samples taken from patients were transported to the laboratory in falcons containing EDTA. To extract DNA, first, the red blood cells of the blood samples were lysed using a lysis buffer solution until after centrifugation, a white sediment containing white blood cells was obtained. DNA extraction from white blood cells was done using the salting out method. Until the next steps, the DNA inside the 1.5 ml microtubes was transferred to a -20°C freezer and kept there. In order to investigate the nc-443C>T and nc-582A>G polymorphisms of the hepcidin gene, first the relevant specific primers were designed by GenRunner software and with the help of the NCBI website, and then by using the PCR technique and direct sequencing of the genotypes related to the polymorphism Hepcidin gene morphisms nc-443C>T and nc-582A>G were determined. SPSS version 25 software was used for data analysis. P<0.05 was considered statistically significant.

Results: In this study, 110 COVID-19 patients with and without mucormycosis were examined. Increased serum levels of urea, aspartate aminotransferase, lactate dehydrogenase and increased ratio of polymorphonuclear neutrophils to lymphocytes were associated with a reduced risk of mucormycosis associated with COVID-19 in patients (all P < 0.05). Also, diabetes mellitus increased the risk of mucormycosis (P=0.028). None of the mucormycosis patients had SNP442 GA and SNP335 GT genotypes, and CC genotype and AA+CC genotype were associated with increased lactate dehydrogenase levels in COVID-19 patients, respectively.