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HLA B53 is associated with a poor outcome in black COVID-19 patients
Allen J Norin1, Rachelle Mendoza2, Michael Augenbraun3
1Department of Medicine and Cell Biology, SUNY Downstate Health Sciences University, Brooklyn, NY 11203, United States.
Insights
The human leukocyte antigen (HLA) B53 allele is more common in Black COVID-19 patients who are hospitalized and have a higher risk of death. This finding may explain some of the disparities in COVID-19 outcomes.
Area of Science:
- Immunogenetics
- Infectious Disease Epidemiology
- Genomic Medicine
Background:
- COVID-19 has disproportionately affected African Americans in the United States, with higher mortality rates.
- Genetic predispositions, including human leukocyte antigen (HLA) associations, may contribute to these disparities.
- Understanding genetic factors is crucial for addressing health inequities in infectious diseases.
Purpose of the Study:
- To investigate the association between specific human leukocyte antigen (HLA) alleles and severe COVID-19 outcomes in a predominantly Black hospitalized population.
- To compare HLA allele frequencies in hospitalized COVID-19 patients with non-hospitalized individuals and national databases.
- To identify potential genetic markers that predict mortality risk in Black COVID-19 patients.
Main Methods:
- Human leukocyte antigen (HLA) typing was performed on hospitalized COVID-19 patients (89% Black) and compared to non-hospitalized individuals who recovered from mild COVID-19.
- Data from kidney transplant recipients and deceased donors were used for additional comparison.
- Patients were followed for 45 days post-admission, with death as the primary endpoint. Statistical analyses included Fisher's exact test and multivariate analysis.
Main Results:
- The HLA B53 allele was found to be more prevalent in hospitalized COVID-19 patients (30.5%) compared to U.S. Black national data (24.5%).
- Non-hospitalized COVID-19 patients showed a significantly lower prevalence of HLA B53 (2.6%) compared to hospitalized patients (p=0.001).
- Hospitalized COVID-19 patients positive for HLA B53 had a significantly higher mortality rate (73%) compared to B53-negative patients (40%).
- Multivariate analysis revealed that HLA B53 positive Black hospitalized COVID-19 patients had a 7.4-fold increased risk of death.
Conclusions:
- The HLA B53 allele is associated with an increased risk of severe disease and mortality in Black patients hospitalized with COVID-19.
- These findings suggest a genetic component contributing to the observed racial disparities in COVID-19 outcomes.
- Consideration for targeted vaccination and early treatment strategies for HLA B53 positive Black individuals is warranted.
Abstract:
A disproportionate incidence of death has occurred in African Americans (Blacks) in the United States due to COVID-19. The reason for this disparity is likely to be multi-factorial and may involve genetic predisposition. The association of human leukocyte antigens (HLA) with severe COVID-19 was examined in a hospitalized population (89% Black, n = 36) and compared to HLA typed non-hospitalized individuals (20% Black, n = 40) who had recovered from mild disease. For additional comparison, HLA typing data was available from kidney transplant recipients and deceased donors. Hospitalized patients were followed for 45 days after admission to our medical center with death as the primary end-point. One HLA allele, B53, appeared to be more prevalent in the hospitalized COVID-19 patients (percent of positive subjects, 30.5) compared to national data in US Black populations (percent of positive subjects, 24.5). The percent B53 positive in non-hospitalized COVID-19 patients was 2.6, significantly less than the percent positive in the hospitalized COVID-19 patients (p = 0.001, Fisher's exact test) and less than the 8 percent positive listed in national data bases for US Caucasian populations. Significantly greater deaths (73 percent) were observed in HLA B53 positive hospitalized COVID-19 patients compared to hospitalized COVID-19 patients who were B53 negative (40 percent). Multi-variate analysis indicated that HLA B53 positive Black hospitalized COVID-19 patients were at a 7.4 fold greater risk of death than Black COVID-19 patients who were B53 negative. Consideration for accelerated vaccination and treatment should be given to HLA B53 positive Black COVID19 patients.
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