Host genetic factors in COVID-19 patients in relation to disease susceptibility, disease severity and pharmacogenomics

1. Pajaree Chariyavilaskul, MD, PhD. Department of Pharmacology, Faculty of Medicine, Chulalongkorn University, Thailand Clinical Pharmacokinetics and Pharmacogenomics Research Unit, Faculty of Medicine, Chulalongkorn University, Thailand Excellent Center of Genomics and Precision Medicine, King Chulalongkorn Memorial Hospital, Thai Red Cross Society, Thailand
2. Monpat Chamnanphol, PhD Department of Pharmacology, Faculty of Medicine, Chulalongkorn University, Thailand Clinical Pharmacokinetics and Pharmacogenomics Research Unit, Faculty of Medicine, Chulalongkorn University, Thailand
3. Noppadol Wacharachaisurapol, MD Department of Pharmacology, Faculty of Medicine, Chulalongkorn University, Thailand Clinical Pharmacokinetics and Pharmacogenomics Research Unit, Faculty of Medicine, Chulalongkorn University, Thailand
4. Voraphoj Nilaratanakul, MD, PhD Division of Infectious Diseases, Department of Medicine, Faculty of Medicine, Chulalongkorn University, Thailand
5. Opass Putcharoen, MD Excellent Center of Clinical Emerging Infectious Disease, King Chulalongkorn Memorial Hospital, Thai Red Cross Society, Thailand
6. Watsmon Jantarabenjakul, MD Excellent Center of Clinical Emerging Infectious Disease, King Chulalongkorn Memorial Hospital, Thai Red Cross Society, Thailand
7. Nattiya Hirankan, MD, PhD Department of Microbiology, Faculty of Medicine, Chulalongkorn University, Thailand
8. Vorasuk Chotelersuk, MD, PhD Department of Pediatrics, Faculty of Medicine, Chulalongkorn University, Thailand Excellent Center of Genomics and Precision Medicine, King Chulalongkorn Memorial Hospital, Thai Red Cross Society, Thailand

Scope

COVID-19 is an infectious disease caused by Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2). It was found pandemically across the globe, including Thailand, with a basic reproductive number (R0) of 2-3. The average death rate is 1-10% across the world. In Thailand, a report from the Department of Disease Control, Ministry of Health showed that there were 2,518 COVID-19 cases in the country on 11th April 2020. Forty five of them were new cases and accumulative death were 35 patients. The rest of 1,262 patients were still hospitalized. For the total number of 2,518 cases, it was shown that 2,043 patients were local spreading while only 475 patients were infected from outside the country. This shows that the COVID-19 outbreak in Thailand is now local spreading. Even though the number of new cases is getting lower every day due to the Government’s rules and regulations during the outbreak, the epidemic/pandemic is not yet finished. This may lead to the problems of dealing with health and medical resource management within the country as many of COVID-19 patients require prolong intubation and medical care in an Intensive Care Unit.

To date, several research groups are interested in COVID-19 research. There are numbers of research projects on with new medical intervention/innovation to help diagnosing and treating patients. These include the quick win projects such as epidemiology of virus, diagnostic kit, N-95 mask and negative pressure room designed. Studies in relation to the efficacy of treatment including hyperimmune globulin from convalescent plasma, antivirals, anti-inflammations and vaccine are also on going.

Our team foresee the importance of host genetic factors including human leukocyte antigen (HLA), angiotensin converting enzyme (ACE) 1 and 2 and the diversity of drug metabolizing enzymes and drug transporters that might affect pharmacokinetics and pharmacodynamics of drugs used in COVID-19 patients. These host genetic factors would help identify individuals who are at risk for disease (disease susceptibility, or disease severity). Also, the data will help tailoring the treatment regimen for the patients and thus improve the overall treatment outcome.

We will collect blood samples from COVID-19 patients who were treated at King Chulalongkorn Memorial Hospital, Thai Red Cross Society, Thailand and Bamrasnaradura Infectious Disease Institute, Ministry of Health, Thailand and study their genetic variations of HLA, ACE1&2 and pharmacogenomics of drug metabolizing enzyme and drug transporters that are related to drug used in COVID-19 (chloroquine/ hydroxychloroquine, darunavir + ritonavir, lopinavir/ritonavir and favipiravir). All genetic data will be related to the disease susceptibility, disease severity and drug response in those patients. These will be an exclusive set of data for our COVID-19 Thai patients.