Abstract
The worldwide spread of COVID-19, triggered by SARS-CoV-2, has highlighted how viral accessory proteins contribute significantly to bypassing host immune defenses and increasing illness severity. This study investigates the relationship between the levels of SARS-CoV-2 subgenomic RNA (sgRNA) for ORF7a and ORF7b and host interferon-beta (IFN-β) expression in hospitalized COVID-19 patients with different prognoses. Upper respiratory tract samples from 89 patients (49 with poor prognosis and 40 with good prognosis) were analyzed using quantitative real-time PCR to measure ORF7a, ORF7b, and IFN-β expression levels. The results revealed significantly higher expression of ORF7a and ORF7b in patients with poor prognosis compared to those with favorable outcomes (P < 0.001). Conversely, IFN-β expression was significantly reduced in the poor prognosis group (P < 0.001), suggesting a potential mechanism of immune suppression. Older age, underlying health conditions, and elevated levels of inflammatory biomarkers, such as CRP and D-dimer, were also associated with poorer outcomes. These findings underscore the potential role of ORF7 proteins in suppressing IFN-β signaling, contributing to disease severity. Targeting these viral proteins may offer promising therapeutic avenues to enhance antiviral responses and improve patient outcomes. The study was conducted from August 2022 to February 2022. Further research is warranted to better understand the interplay between viral immune evasion mechanisms and host responses across diverse patient populations.