الفهرس 
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Abstract
Background: The COVID-19 pandemic is a global outbreak of coronavirus, an infectious disease caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) virus that causes most of infected people to experience mild to moderate respiratory illness and recover without requiring special treatment, however, some become seriously ill and require medical attention. COVID-19 patients are at a high risk of developing coagulopathy and thrombosis, conditions that elevate levels of D-dimer. It is believed that homocysteine, an amino acid that plays a crucial role in coagulation, also contributes to these conditions. Multiple gene mutations are implicated in the development of these disorders by mediating differences in homocysteine levels, such as, MTHFR gene mutations. Aim: The aim of the present study was to evaluate the role of serum Homocysteine level and MTHFR gene mutations; MTHFR C677T (rs1801133), MTHFR A1298C (rs1801131), MTR A2756G (rs1805087), and MTRR A66G (rs1801394) as risk factors for thrombosis in both non-complicated and complicated COVID-19 cases. Subjects and Methods: The present study was a case control study that was conducted on 33 healthy control individuals and 67 COVID-19 cases divided into 33 non-complicated cases and 34 complicated cases. All the participants were subjected to full history taking, clinical evaluation and the following investigations: Chest CT for COVID-19 cases, CBC, SGPT, SGOT, albumin, total bilirubin, creatinine, LDH, CRP, INR, and D-dimer. Homocysteine level assay using Competitive Immunoassay technique and MTHFR gene mutation detection using Real-Time PCR technique. Results: The present study revealed that Homocysteine and MTHFR gene mutations; MTHFR C677T, MTHFR A1298C, MTR A2756G, and MTRR A66G are significantly correlated with thrombosis among COVID-19 both non-complicated and complicated patients (p<0.05, OR>1 each). Also, it revealed that Homocysteine and MTHFR gene mutations; MTHFR C677T, MTHFR A1298C, MTR A2756G, and MTRR A66G are considered independent predictors of susceptibility to thrombosis among COVID-19 patients (p<0.05, OR>1 each). Conclusion: from this study we concluded that Homocysteine and MTHFR gene mutations; MTHFR C677T, MTHFR A1298C, MTR A2756G, and MTRR A66G are significant risk factors for thrombosis in both non-complicated and complicated COVID-19 cases and thus are good diagnostic and prognostic markers that can help, along with D-dimer and other current markers, in early diagnosis of thrombosis and, as a result, provide a better outcome in COVID-19 patients. Keywords: COVID-19, Thrombosis, Homocysteine, MTHFR.