Individuals with no known comorbidities or risk factors may develop severe coronavirus disease 2019 (COVID-19). The present study assessed the effect of certain host polymorphisms and viral lineage on the severity of COVID-19 among hospitalized patients with no known comorbidities in Mexico. The analysis included 117 unrelated hospitalized patients with COVID-19. Patients were stratified by whether they required intensive care unit (ICU) admission: the ICU group (n = 40) and non-ICU group (n = 77). COVID-19 was diagnosed on the basis of a positive severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) reverse transcription-polymerase chain reaction (RT-PCR) assay and clinical and radiographic criteria. The presence of the IL1B-31 (T/C) polymorphism was determined for all patients using PCR and nucleotide sequencing. Genotyping of the IL-4 (-590, T/C) and IL-8 (-251, T/A) polymorphisms was performed by the amplification refractory mutation system-PCR method. Genotyping of IL1-RN was performed using PCR. Viral genome sequencing was performed using the ARTIC Network amplicon sequencing protocol using a MinION. Logistic regression analysis identified the carriage of IL-1 B*-31 *C as an independent potential risk factor (odds ratio [OR] = 3.1736, 95% confidence interval [CI] = 1.0748-9.3705, p = 0.0366) for ICU admission and the presence of IL-RN*2 as a protective factor (OR = 0.4371, 95% CI = 0.1935-0.9871, p = 0.0465) against ICU admission. Under the codominant model, the CC genotype of IL1B-31 significantly increased the risk of ICU admission (OR: 6.38, 95% CI: 11.57-25.86, p < 0.024). The IL1B-31 *C-IL-4-590 *T haplotype increased the risk of ICU admission (OR = 2.53, 95% CI = 1.02-6.25, p = 0.047). The 42 SARS-CoV-2 genomes sequenced belonged to four clades, 20A-20D. No association was detected between SARS-CoV-2 clades and ICU admission or death. Thus, in patients with no known comorbidities or risk factors, the IL1B-31*C proinflammatory allele was observed to be associated with the risk of ICU admission owing to COVID-19.

中文翻译：

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白细胞介素 1B-31*C 促炎等位基因与 COVID-19 患者严重程度的关联：初步报告。

没有已知合并症或危险因素的个人可能会患上严重的冠状病毒病 2019 (COVID-19)。本研究评估了某些宿主多态性和病毒谱系对墨西哥没有已知合并症的住院患者 COVID-19 严重程度的影响。该分析包括 117 名无关的 COVID-19 住院患者。根据是否需要入住重症监护室 (ICU) 对患者进行分层：ICU 组 (n = 40) 和非 ICU 组 (n = 77)。COVID-19 是根据严重急性呼吸系统综合症冠状病毒 2 (SARS-CoV-2) 逆转录聚合酶链反应 (RT-PCR) 检测呈阳性以及临床和影像学标准诊断出来的。使用 PCR 和核苷酸测序确定所有患者是否存在 IL1B-31 (T/C) 多态性。IL-4（-590，T/C）和IL-8（-251，T/A）多态性的基因分型通过扩增难治性突变系统-PCR方法进行。使用 PCR 对 IL1-RN 进行基因分型。病毒基因组测序是使用 ARTIC Network 扩增子测序方案和 MinION 进行的。逻辑回归分析将 IL-1 B*-31 *C 的携带确定为入住 ICU 的独立潜在风险因素（比值比 [OR] = 3.1736，95% 置信区间 [CI] = 1.0748-9.3705，p = 0.0366） IL-RN*2 的存在作为防止入住 ICU 的保护因素（OR = 0.4371，95% CI = 0.1935-0.9871，p = 0.0465）。在共显性模型下，IL1B-31 的 CC 基因型显着增加了入住 ICU 的风险（OR：6.38，95% CI：11.57-25.86，p < 0.024）。IL1B-31 *C-IL-4-590 *T 单倍型增加了入住 ICU 的风险（OR = 2.53，95% CI = 1.02-6.25，p = 0.047）。测序的 42 个 SARS-CoV-2 基因组属于四个进化枝，20A-20D。未检测到 SARS-CoV-2 进化枝与 ICU 入院或死亡之间存在关联。因此，在没有已知合并症或危险因素的患者中，观察到 IL1B-31*C 促炎等位基因与因 COVID-19 而入住 ICU 的风险相关。