Recently, a genome-wide association study for Covid-19 came out in the New England Journal of Medicine, and several associations of notice have been discovered. Importantly, these links cannot indicate with certainty any causality, only association. The Severe Covid-19 GWAS Group performed a genome wide association study involving nearly 2000 patients with severe Covid-19 (i.e. respiratory failure) at different hospitals in Italy and Spain. They found significant correlation at locus 3 as well as 9 at odds ratios of 1.77 and 1.32 respectively. The association at locus 9 was associated with ABO blood groups, and further investigation showed blood group A has higher risk (odds ratio 1.45) and blood O group exhibited a protective effect (0.65). Odds ratio describes the chance of an event occurring divided by the event not occurring; thus an odds ratio above 1 is seen as positively correlated and below 1 as negatively correlated. It is important to point out that 1.77 may seem very significant, but could really be 90% chance of the event occurring in the numerator and 50% in the denominator, which in a sample size of 1000 is worth considering.
The researchers performed a genome-wide meta-analysis and then for the blood type study they selected ABO SNPs and SNPS for the HLA loci. The association signal for the 3 locus interestingly included alleles associated with lung cells, as well as one gene SLC6A20 which codes for sodium-amino acid transporter that interacts with the ACE-2 SARS CoV 2 surface receptor. The locus also had genes that encoded chemokine receptors, including one which regulates the lung memory Cd8 T cells. These findings have implications for who has risk factors for severe COVID. In terms of the blood groups, scientists still aren’t sure why the O blood group may have a protective effect, so this requires further investigation, and again, the link is still tenuous and no causality is present.
https://www.nejm.org/doi/10.1056/NEJMoa2020283
-Sammy
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