ABSTRACT
BACKGROUND Constant mutation in the SARS-COV2 virus genetic material is resulting in the appearance of new variants frequently hence the overall virulence, treatment resistance, replication modalities, transmissions rates and COVID-19 signs & symptoms are all changing regularly. METHODOLOGY: From 1 January 2021 to 30 August 2022, the clinical lab at Fatima Jinnah General & Chest Hospital Quetta, Balochistan, determined a total of 3375 individuals to be COVID-19 positive because RT-PCR detected ORF, N, and E genes or their various Bi & Tri combinations in their samples. A questionnaire-based interview was conducted with each participant during sample collection. Body temperature more than 370c was recorded as Fever/Chill. Age, Comorbidities, A-symptomatic individuals & Vaccination status were all neglected during this study. Frequency tables were generated using MS-excel 2016, while Odds ratios were calculated using Chi-square test of association whereby 2x2 contingency tables between Mono, Bi & Tri combinations for ORF, N & E genes were cross associated with various generalized nonspecific COVID -19 signs and symptoms using Epi-info software. Absence of Genetic sequencing was the major limitation. RESULTS: The study showed that individually the presence of ORF gene was found to be strongly associated Shortness of Breath/Difficulty in Breathing, Diarrhea, Head ache & Vomitting. While the presence of N-gene was found to be strongly associated with Loss of smell & taste, Head ache,Presistant Chest Pain & Bluish lips/Face. Where as the presence of E-gene was found to be strongly associated with Cough, Shortness of breath/ Difficulty in breathing, Sore throat, Diarrhea, Head ache & Laziness. In addition, the study also found that different Bi & Tri combinations of ORF, N & E genes in a COVID-19 positive patient expressed generalized non-specific COVID-19 signs & symptoms differently. DISCUSSION & CONCLUSION: The presence of various SARS-COV2 genetic markers significantly alters the clinical presentation of COVID-19.