Does human leukocyte antigen gene polymorphism affect management of COVID-19 Patients? A review article

New corona virus disease (COVID-19) is a recent worldwide pandemic occurred as a result of SARS-CoV-2 virus, where, it spreads mainly through large respiratory droplets, and probability of other routes of transmission do exist, due to the suspicion of the viral abundance in feces and urine of affected individuals [1]. The transfer and transmission of COVID-19 is high and occurs via respiratory secretions, where, the virus invades the body through the inner wall cells of upper respiratory tract causing severe injury of the lungs, affecting its performance, and consequently respiration efficiency [2]. Transmission between individuals occurs mainly through direct contact or droplets spread by sneezing or coughing from carrier individual which is accompanied by binding of SARS-COV spikes to the ACE2 cellular receptor expressed by lung epithelial cells which is the first step of the viral infection followed by fusion with the cell membrane. Concerning the clinical findings of COVID-19 infection, it was found that there is an increased levels of plasma pro-inflammatory cytokines like IL1-β, IL1RA, IL7, IL8, IL9, IL10, TNFα, leucopenia, elevated C-reactive protein, elevated D-dimer, and high ESR [3]. However, most of the infected patients showed a mild clinical presentation of the disease, while others have developed severe signs and symptoms characterized by respiratory compromise [4]. It is well-known that the genome is the human DNA, his /her genes and their expressions which in turn give the different specific characteristic of the human being. Moreover, the thousands of genetic variations among people are reported for each allele which is called Snips (SNPs). In fact, diploid people with two different alleles types known as (Heterozygous) are more likely to develop polymorphism, than those with the same allele type (Homozygous), especially in those environments rich with pathogens. It is assumed that different Human Leukocyte Antigen (HLA) molecules are supporting potential to present peptides derived from ...