Avaliação da Expressão de Genes Imunológicos Interferon Tipo 1 e Receptores IFNAR1 e IFNAR2, Interleucina 17A e Retrovírus Endógenos (HERVK-10 e HERVW-1) no sangue periférico e associação com a gravidade nos pacientes com COVID-19.

Abstract

Introduction: COVID-19 is characterized by hyperactivation of the immune system and uncontrolled release of cytokines. Recent studies indicate that impaired signaling of IFNA1 and its receptors, IL17A, HERVs and IFN-γ may be associated with the severity of COVID-19. Objective: To analyze the expression of IFNA1 genes and IFNAR1/IFNAR2 receptors, IL17A and HERVs (HERVK-10 and HERVW-1) in total leukocytes and baseline levels of IFN-γ in the plasma of patients with COVID-19. Methods: Prospective, observational and cross-sectional study with 117 recruited patients (severe=58 and mild=59). Demographic and clinical data were collected. Peripheral blood leukocytes were isolated and RT-qPCR assay was performed for gene expression analysis. Plasma levels of IFN-γ were measured by the ELISA method. Results: Among the evaluated sample, there was a prevalence of males (p<0.05), elderly (p<0.0001), blacks (p<0.0001) and pre-existing comorbidities (p<0.0001). Patients with severe COVID-19 had leukocytosis, neutrophilia, and elevated platelet counts with reduced lymphocytes compared with mild patients (p<0.0001). The SII, AISI and SII/Hb indexes were significantly higher in critically ill patients (p<0.0001). IFNA1, HERVW-1 and IL17A gene expression levels were significantly higher in critically ill patients (p<0.05, p<0.05, p<0.001, respectively). However, plasma levels of IFN- γ were not significant. ROC analysis showed that SII and SII/Hb indexes are good prognostic markers for the outcome of COVID-19, with AUC (0.98, 0.99, p<0.0001, respectively). Conclusion: Our results indicate that the segment most affected by COVID-19 comprises men, the elderly, black people and those with comorbidities, with higher gene expression of IFNA1, HERVW-1 and IL17A. Indices such as SII and SII/Hb can be promising predictors of severity for COVID-19.