Investigation of HLA DRB1*09:01 polymorphism and its association with COVID-19 severity in Indonesian population

Abstract

Coronavirus disease 2019 (COVID-19) manifests in a wide range of degrees of severity, ranging from asymptomatic to critical disease with high risk of mortality. Gene polymorphism has been found to be associated with severe COVID-19 in different populations around the world. Human Leukocyte Antigen (HLA)‐DRB1*09:01, in particular, has appeared to be more significantly associated with severe COVID‐19 compared to pre-existing comorbidities in a study involving an Asian population. This study investigated HLA‐DRB1*09:01 polymorphism in Indonesian patients who were hospitalized in Sebelas Maret University Hospital with COVID-19 from October 2021 to October 2022 and analyzed whether there is an association with severe COVID-19. Of 154 subjects in total, 102 were non-severe and 52 were severe. We reviewed four single nucleotide polymorphisms (SNP) of HLA-DRB1*09:01, namely rs75314265, rs79572840, rs117501019, and rs11708573. The SNP rs 79572840 population was entirely heterozygote (100%) in both non-severe and severe groups. In both severity groups, SNP rs75314265 was dominated by heterozygote alleles, while rs117501019 and rs11708573 were dominated by homozygote alleles. None of the SNPs were significantly associated with severe COVID-19. Subject characteristics associated with severity were of older age, having comorbidities and higher neutrophil to lymphocyte ratio (p=0.010, 0.030, 0.001, respectively), which potentially confounded the effect of HLA polymorphisms on COVID-19 severity in this study. Gene polymorphism among different populations is a natural phenomenon, hence different studies may yield different conclusions about HLA’s association with COVID-19 severity. Further studies involving more cases over various populations may allow better understanding of genetic markers linked to disease outcomes and prognosis.

Keywords

• COVID-19
• severity
• risk factor
• HLA-DRB
• polymorphism

Supporting Institution

Sebelas Maret University, Surakarta, Indonesia as provider of funding through research grant

Ethical Statement

This study has obtained ethical approval from Ethical Committee of Sebelas Maret University under the reference number 46/UN27.06.6.1/KEP/EC/2021.

Thanks

None to declare

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