Abstract
Introduction and Aim: Coronavirus disease (COVID-19) is an infectious disease caused by the SARS-CoV-2 virus. Once infected this virus induces several clinical disorders in humans. SARSCoV-2 enters cells via TMPRSS2. Genetic variation in TMPRSS2 could affect the severity of infection. The purpose of this study was to investigate how the (TMPRSS2) gene polymorphism affected COVID-19 severity in patients as well as the effect of age and comorbidities on infection.
 
 Materials and Methods: This cross-sectional analytical study comprised of 400 (185 male, 215 female) Covid-19-infected patients between ages 18-65 receiving treatment in hospitals at Baghdad, Iraq. The patients were divided into three groups: mild, moderate, and severe based on the severity of Covid-19 infection. Baseline data was collected for each patient through interview and questionnaire. Blood collected from patients was subjected to DNA extraction and detecting polymorphisms within SNPs of the TMPRSS2 gene.
 
 Results: The present investigation indicated higher age to be significantly associated with severe COVID-19 infection when compared to moderate and mild infection (36.14 ± 12.716 vs. 48.52 ± 17.513 vs. 59.26 ± 16.035) (F= 3.697, df: 64, P= 0.000). Patients with comorbidities was associated with a greater rate of severe Covid-19 infection (74.2% vs. 25.8%). However, individuals without comorbidities had a considerably lower rate of mild and moderate Covid-19 infection (13.9% vs. 86.1%) and (36% vs. 64%), respectively (x^2: 97.930, df: 2, P = 0.000). SNPs; (rs383510, rs12329760) within the transmembrane TMPRSS2–7113 was studied and we found no significant (P> 0.05) association for these SNPs to severity of Covid-19 infection.
 
 Conclusion: The results show that the allelic variation within the TMPRSS2 (SNP rs2070788) gene to be linked to increasing illness severity in COVID-19 patients.
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