Background: There is considerable variation in disease behavior among patients infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the virus that causes coronavirus disease 2019 (Covid-19). Genomewide association analysis may allow for the identification of potential genetic factors involved in the development of Covid-19. Methods: We conducted a genomewide association study involving 1980 patients with Covid-19 and severe disease (defined as respiratory failure) at seven hospitals in the Italian and Spanish epicenters of the SARS-CoV-2 pandemic in Europe. After quality control and the exclusion of population outliers, 835 patients and 1255 control participants from Italy and 775 patients and 950 control participants from Spain were included in the final analysis. In total, we analyzed 8,582,968 single-nucleotide polymorphisms and conducted a meta-analysis of the two case-control panels. Results: We detected cross-replicating associations with rs11385942 at locus 3p21.31 and with rs657152 at locus 9q34.2, which were significant at the genomewide level (P<5×10-8) in the meta-analysis of the two case-control panels (odds ratio, 1.77; 95% confidence interval [CI], 1.48 to 2.11; P = 1.15×10-10; and odds ratio, 1.32; 95% CI, 1.20 to 1.47; P = 4.95×10-8, respectively). At locus 3p21.31, the association signal spanned the genes SLC6A20, LZTFL1, CCR9, FYCO1, CXCR6 and XCR1. The association signal at locus 9q34.2 coincided with the ABO blood group locus; in this cohort, a blood-group-specific analysis showed a higher risk in blood group A than in other blood groups (odds ratio, 1.45; 95% CI, 1.20 to 1.75; P = 1.48×10-4) and a protective effect in blood group O as compared with other blood groups (odds ratio, 0.65; 95% CI, 0.53 to 0.79; P = 1.06×10-5). Conclusions: We identified a 3p21.31 gene cluster as a genetic susceptibility locus in patients with Covid-19 with respiratory failure and confirmed a potential involvement of the ABO blood-group system.
Genomewide Association Study of Severe Covid-19 with Respiratory Failure / D. Ellinghaus, F. Degenhardt, L. Bujanda, M. Buti, A. Albillos, P. Invernizzi, J. Fernández, D. Prati, G. Baselli, R. Asselta, M.M. Grimsrud, C. Milani, F. Aziz, J. Kässens, S. May, M. Wendorff, L. Wienbrandt, F. Uellendahl-Werth, T. Zheng, X. Yi, R. de Pablo, A.G. Chercoles, A. Palom, A. Garcia-Fernandez, F. Rodriguez-Frias, A. Zanella, A. Bandera, A. Protti, A. Aghemo, A. Lleo, A. Biondi, A. Caballero-Garralda, A. Gori, A. Tanck, A. Carreras Nolla, A. Latiano, A.L. Fracanzani, A. Peschuck, A. Julià, A. Pesenti, A. Voza, D. Jiménez, B. Mateos, B. Nafria Jimenez, C. Quereda, C. Paccapelo, C. Gassner, C. Angelini, C. Cea, A. Solier, D. Pestaña, E. Muñiz-Diaz, E. Sandoval, E.M. Paraboschi, E. Navas, F. García Sánchez, F. Ceriotti, F. Martinelli-Boneschi, F. Peyvandi, F. Blasi, L. Téllez, A. Blanco-Grau, G. Hemmrich-Stanisak, G. Grasselli, G. Costantino, G. Cardamone, G. Foti, S. Aneli, H. Kurihara, H. ElAbd, I. My, I. Galván-Femenia, J. Martín, J. Erdmann, J. Ferrusquía-Acosta, K. Garcia-Etxebarria, L. Izquierdo-Sanchez, L.R. Bettini, L. Sumoy, L. Terranova, L. Moreira, L. Santoro, L. Scudeller, F. Mesonero, L. Roade, M.C. Rühlemann, M. Schaefer, M. Carrabba, M. Riveiro-Barciela, M.E. Figuera Basso, M.G. Valsecchi, M. Hernandez-Tejero, M. Acosta-Herrera, M. D’Angiò, M. Baldini, M. Cazzaniga, M. Schulzky, M. Cecconi, M. Wittig, M. Ciccarelli, M. Rodríguez-Gandía, M. Bocciolone, M. Miozzo, N. Montano, N. Braun, N. Sacchi, N. Martínez, O. Özer, O. Palmieri, P. Faverio, P. Preatoni, P. Bonfanti, P. Omodei, P. Tentorio, P. Castro, P.M. Rodrigues, A. Blandino Ortiz, R. de Cid, R. Ferrer, R. Gualtierotti, R. Nieto, S. Goerg, S. Badalamenti, S. Marsal, G. Matullo, S. Pelusi, S. Juzenas, S. Aliberti, V. Monzani, V. Moreno, T. Wesse, T.L. Lenz, T. Pumarola, V. Rimoldi, S. Bosari, W. Albrecht, W. Peter, M. Romero-Gómez, M. D’Amato, S. Duga, J.M. Banales, J.R. Hov, T. Folseraas, L. Valenti, A. Franke, T.H. Karlsen. - In: NEW ENGLAND JOURNAL OF MEDICINE. - ISSN 0028-4793. - (2020). [Epub ahead of print]
Genomewide Association Study of Severe Covid-19 with Respiratory Failure
G. BaselliMembro del Collaboration Group
;R. AsseltaMembro del Collaboration Group
;A. ZanellaMembro del Collaboration Group
;A. BanderaMembro del Collaboration Group
;A. ProttiMembro del Collaboration Group
;A. AghemoMembro del Collaboration Group
;A. LleoMembro del Collaboration Group
;A. GoriMembro del Collaboration Group
;A.L. FracanzaniMembro del Collaboration Group
;A. PesentiMembro del Collaboration Group
;C. PaccapeloMembro del Collaboration Group
;E.M. ParaboschiMembro del Collaboration Group
;F. Martinelli-BoneschiMembro del Collaboration Group
;F. PeyvandiMembro del Collaboration Group
;F. BlasiMembro del Collaboration Group
;G. GrasselliMembro del Collaboration Group
;G. CostantinoMembro del Collaboration Group
;L. TerranovaMembro del Collaboration Group
;M. CarrabbaMembro del Collaboration Group
;M. MiozzoMembro del Collaboration Group
;N. MontanoMembro del Collaboration Group
;N. SacchiMembro del Collaboration Group
;P. PreatoniMembro del Collaboration Group
;P. BonfantiMembro del Collaboration Group
;R. GualtierottiMembro del Collaboration Group
;S. PelusiMembro del Collaboration Group
;S. AlibertiMembro del Collaboration Group
;V. RimoldiMembro del Collaboration Group
;S. BosariMembro del Collaboration Group
;S. DugaMembro del Collaboration Group
;L. ValentiMembro del Collaboration Group
;
2020
Abstract
Background: There is considerable variation in disease behavior among patients infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the virus that causes coronavirus disease 2019 (Covid-19). Genomewide association analysis may allow for the identification of potential genetic factors involved in the development of Covid-19. Methods: We conducted a genomewide association study involving 1980 patients with Covid-19 and severe disease (defined as respiratory failure) at seven hospitals in the Italian and Spanish epicenters of the SARS-CoV-2 pandemic in Europe. After quality control and the exclusion of population outliers, 835 patients and 1255 control participants from Italy and 775 patients and 950 control participants from Spain were included in the final analysis. In total, we analyzed 8,582,968 single-nucleotide polymorphisms and conducted a meta-analysis of the two case-control panels. Results: We detected cross-replicating associations with rs11385942 at locus 3p21.31 and with rs657152 at locus 9q34.2, which were significant at the genomewide level (P<5×10-8) in the meta-analysis of the two case-control panels (odds ratio, 1.77; 95% confidence interval [CI], 1.48 to 2.11; P = 1.15×10-10; and odds ratio, 1.32; 95% CI, 1.20 to 1.47; P = 4.95×10-8, respectively). At locus 3p21.31, the association signal spanned the genes SLC6A20, LZTFL1, CCR9, FYCO1, CXCR6 and XCR1. The association signal at locus 9q34.2 coincided with the ABO blood group locus; in this cohort, a blood-group-specific analysis showed a higher risk in blood group A than in other blood groups (odds ratio, 1.45; 95% CI, 1.20 to 1.75; P = 1.48×10-4) and a protective effect in blood group O as compared with other blood groups (odds ratio, 0.65; 95% CI, 0.53 to 0.79; P = 1.06×10-5). Conclusions: We identified a 3p21.31 gene cluster as a genetic susceptibility locus in patients with Covid-19 with respiratory failure and confirmed a potential involvement of the ABO blood-group system.
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Genomewide association study of severe COVID 19 with respiratory failure NEJM 2020.pdf
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