Large genetic study on severe COVID-19
Bonn researchers confirm three other genes for increased risk in addition to the known TLR7 gene
Even though the number of severe cases following infection with the SARS-CoV-2 virus has decreased, there is still great interest in understanding why, at the height of the coronavirus pandemic, the infection was severe in some people but not in others. "This is important because it gives us information about the function and reaction of the immune system when it first comes into contact with a pathogen. If we have a better understanding of how severe courses of the disease develop, we can identify people at risk and protect them better or develop targeted therapies. We assume that the findings can be transferred at least in part to future pandemics," says corresponding author Prof. Kerstin Ludwig from the Institute of Human Genetics at the UKB, who is also a member of the Cluster of Excellence ImmunoSensation2 and the Transdisciplinary Research Area TRA "Life and Health" at the University of Bonn.
In addition to many possible reasons such as increased age or pre-existing conditions, some people's own genetic make-up can cause a severe course of the disease. Early work in the pandemic had already identified affected genes, most of which are involved in the innate immune response. The gene with the strongest evidence to date is the TLR7 gene, which was identified as the cause of the disease in two pairs of Dutch brothers with severe cases back in summer 2020. However, it was not yet known to what extent the effect of genetic changes in TLR7 is independent of other non-genetic risk factors, such as increased age or previous illnesses, and whether there are other genes in which so-called mutations significantly increase the risk of severe COVID.
Increased risk of severe Covid-19 lies in three other genes in addition to TLR7
In this large group of people, mutations that render the TLR7 gene non-functional were actually observed significantly more frequently in severely affected COVID-19 patients than in the control group. "This 'enrichment' was even stronger when only those affected people were considered who, due to their age and state of health, would not actually have had a high risk of a severe course. This means that certain mutations in this gene significantly increase the risk of severe progression," says first author and doctoral student at the Bonn Institute of Human Genetics Jannik Boos, who was in charge of the project. In addition to TLR7, the Bonn researchers were also able to identify mutations in the three other genes TBK1, INFAR1 and IFIH1 in the group of severely affected individuals.
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