Genetic study of over 57,000 people provides insight into severity of COVID-19
Some 16 new genetic variants associated with severe Covid-19, including some linked to blood clotting, immune response and intensity of inflammation, have been identified.
These findings will serve as a roadmap for future efforts, opening up new areas of research focused on potential new therapies and diagnostics with pinpoint accuracy, experts say.
Researchers from the GenOMICC consortium – a global collaboration to study genetics in serious diseases – led by the University of Edinburgh in partnership with Genomics England, made the discoveries by sequencing the genomes of 7,491 patients from 224 intensive care units United Kingdom.
Their DNA was compared to 48,400 other people who had not had Covid-19, to participants in Genomics England’s 100,000 Genomes project and to that of 1,630 other people who had experienced mild Covid.
Determining the complete genome sequence for all study participants allowed the team to create an accurate map and identify genetic variation related to the severity of Covid-19. The team found key differences in 16 genes in intensive care patients compared to DNA from other groups.
Our latest findings point to specific molecular targets in critical Covid-19. These results explain why some people develop life-threatening Covid-19, while others have no symptoms. But more importantly, it gives us a deeper understanding of the disease process and is a big step forward in the search for more effective treatments. It is now true to say that we understand the mechanisms of Covid better than the other syndromes that we treat in intensive care in normal times – sepsis, influenza, and other forms of serious illness. Covid-19 shows us the way to solve these problems in the future.
They also confirmed the involvement of seven other genetic variations already associated with severe Covid-19 discovered in previous studies by the same team.
Findings included how a single gene variant that disrupts a key messenger molecule in immune system signaling – called interferon alpha-10 – was enough to increase a patient’s risk of severe disease.
This highlights the gene’s key role in the immune system and suggests that treating patients with interferon – proteins released by immune cells to defend against viruses – may help manage the disease in the early stages. .
The study also found that variations in genes that control levels of a central component of blood clotting – known as factor 8 – were associated with severe disease in Covid-19.
This may explain some of the clotting abnormalities seen in severe cases of Covid-19. Factor 8 is the gene underlying the most common type of hemophilia.
As Covid-19 evolves, we must focus on reducing the number of people becoming seriously ill and hospitalized. Through all of our genome sequencing research, we have discovered new gene variants that predispose people to serious diseases – which now offer a pathway to new tests and treatments, to help protect the public and the NHS against this virus.
Strategically, we are at a point where genomic science is becoming an integral part of the national routine health care infrastructure. This represents a big step forward in our understanding of how our genetic makeup influences serious disease with Covid-19. Everyone involved in the study has gone to great lengths to engage with all communities in the UK, including groups that have historically been under-represented in medical studies. The inclusive element of our work has generated meaningful results for everyone in the country.
GenOMICC (Genetics of Susceptibility and Mortality in Critical Care) began in 2015 as an open global consortium of critical care clinicians dedicated to understanding the genetic factors influencing critical care outcomes of diseases such as SARS, influenza and sepsis.
The consortium is led by the University of Edinburgh and since 2020 has focused on Covid-19 research in partnership with Genomics England and in collaboration with NHS Lothian, the National Center for Audit and Care Research (ICNARC) and Queen Mary University. from London. These latest findings were published in Nature.
The groundbreaking 100,000 Genomes Project was created in 2014 to sequence 100,000 genomes from people with a rare disease or cancer. The project was completed in 2018 and paved the way for the creation of a new genomic medicine service for NHS England, transforming patient care by providing advanced diagnosis and personalized treatments.
Clinical research has been vital in our fight against Covid-19 and innovation from the UK is enabling us to transform our health service and ensure the NHS is able to deliver world-class care. This research is an important step forward in better understanding how Covid-19 impacts certain people, allowing us to take the necessary measures to protect the most vulnerable and save lives.
GenOMICC is funded by DHSC, LifeArc, charity Sepsis Research FEAT, Intensive Care Society, Wellcome, UK Research and Innovation, Scotland’s Chief Scientist Office, Department of Health and Social Care and the National Institute for Health Research (NIHR), and supported by Illumina.
Reference: Kousathanas A, Pairo-Castineira E, Rawlik K, et al. Whole genome sequencing reveals host factors underlying critical Covid-19. Nature. 2022. doi: 10.1038/s41586-022-04576-6.
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