Key result
The 3p21.31 locus variant is linked to ~303% higher severe COVID-19 risk.
Why the study?
Cohort-based joint analyses of variants from the entire allelic spectrum in individuals with confirmed SARS-CoV-2 infections were lacking to understand host genetic contributions to COVID-19 variability.
Observational (n=1,220)
Yes
Whole genome sequencing of COVID-19 patients confirms known risk loci such as 3p21 and highlights the role of rare variants in interferon immune response genes and polygenic risk scores in disease severity.
Answers are grounded in this paper and cite their sources.
May refine age-specific COVID-19 risk prediction; leaves open clinical utility pending prospective validation.
Courses of SARS-CoV-2 infections are highly variable, ranging from asymptomatic to lethal COVID-19. Though research has shown that host genetic factors contribute to this variability, cohort-based joint analyses of variants from the entire allelic spectrum in individuals with confirmed SARS-CoV-2 infections are still lacking. Here, we present the results of whole genome sequencing in 1,220 mainly vaccine-naïve individuals with confirmed SARS-CoV-2 infection, including 827 hospitalized COVID-19 cases. We observed the presence of autosomal-recessive or likely compound heterozygous monogenic disorders in six individuals, all of which were hospitalized and significantly younger than the rest of the cohort. We did not observe any suggestive causal variants in or around the established risk gene TLR7. Burden testing in the largest population subgroup (i.e., Europeans) suggested nominal enrichments of rare variants in coding and non-coding regions of interferon immune response genes in the overall analysis and male subgroup. Case-control analyses of more common variants confirmed associations with previously reported risk loci, with the key locus at 3p21 reaching genome-wide significance. Polygenic scores accurately captured risk in an age-dependent manner. By enabling joint analyses of different types of variation across the entire frequency spectrum, this data will continue to contribute to the elucidation of COVID-19 etiology.
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Schmidt et al. (2024) conducted an observational in COVID-19 (n=1,220). Genetic variants (e.g., 3p21.31 locus) vs. Non-carriers / ambulatory mild COVID-19 cases was evaluated on Severe COVID-19 (hospitalized severe vs ambulatory mild) (OR 4.03, 95% CI 2.56-6.37, p=0.0000000021). The common lead variant at the 3p21.31 locus was strongly associated with severe COVID-19, and polygenic risk scores accurately captured risk in an age-dependent manner.
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