High-resolution HLA genotyping identifies alleles associated with severe COVID-19: A preliminary study from India

Human leukocyte antigen (HLA) variability has been demonstrated to be associated with susceptibility/severity of COVID-19. High-resolution HLA genotyping to identify alleles associated with severe COVID-19 in an Indian cohort was performed.

Quantitative reverse-transcription polymerase chain reaction-confirmed SARS-CoV-2-positive patients with mild/moderate/severe disease (n = 54) and asymptomatic (n = 42) were recruited and genotyped for 11-HLA loci on MiSeq using NGSgo®-MX11-3 and analyzed (NGSengine; GenDx).

A significant difference in alleles between the groups was identified for HLA-C*04:01:01:01, HLA-DRB5*01:01:01:02, HLA-DQA1*03:01:01:01, HLA-DPB1*04:01:01:41, and HLA-DPA1*01:03:01:02. Alleles namely, HLA-C*04:01:01:01 (OR: 5.71; 95% CI: 1.2-27.14; p = .02), HLA-DRB5*01:01:01:02 (OR: 2.94; 95% CI: 1.1-7.84; p = .03), DQA1*03:01:01:01 (OR: 22.47; 95% CI: 1.28-393.5; p = .03), HLA-DPB1*04:01:01:41 (OR: 9.44; 95% CI: 0.5-175.81; p = .13), and HLA-DPA1*01:03:01:02 (OR: 8.27; 95% CI: 2.26-30.21; p = .001) were associated with severe COVID-19.

Genotyping for these alleles will enable identification of individuals at risk of severe disease and stratification for preferential vaccination.