Host vs. Virus
Only a small proportion of patients with SARS-CoV-2 infection have respiratory compromise, a respiratory distress syndrome, and multiorgan failure. Who is to blame, the virus or the host? To help answer this question, Andre Franke, Tom Karlsen and 404 colleagues, on behalf of The Severe Covid-19 GWAS Group, conducted a genomewide association study involving 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: 835 patients and 1255 control participants from Italy and 775 patients and 950 control participants from Spain. The group identified associations between the risk of severe Covid-19 and a multigene locus at 3p21.31 and the ABO blood group locus at 9q34.2. The HLA region did not show any association signal.
Severe Covid-19 GWAS Group, Ellinghaus D, Degenhardt F, et al. Genomewide Association Study of Severe Covid-19 with Respiratory Failure. N Engl J Med. 2020 Oct 15;383(16):1522-1534. PubMed: https://pubmed.gov/32558485. Full-text: https://doi.org/10.1056/NEJMoa2020283
See also the comment by Kaser A. Genetic Risk of Severe Covid-19. N Engl J Med. 2020 Oct 15;383(16):1590-1591. PubMed: https://pubmed.gov/33053291. Full-text: https://doi.org/10.1056/NEJMe2025501. The preliminary response to our initial question: The determinants of disease severity appear to reside almost exclusively in host factors, not in viral genetic variation.
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