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Associations between polygenic risk score and covid-19 susceptibility and severity across ethnic groups: UK Biobank
Raabia Farooqi1, Jaspal S Kooner2,3,4,5, Weihua Zhang6,2
1Department of Epidemiology and Biostatistics, Imperial College London, London, W2 1PG, UK. raabia.farooqi18@imperial.ac.uk.
Insights
Polygenic Risk Scores (PRS) reveal genetic links to COVID-19 severity, particularly in Asian and Black ethnic groups. This genetic risk assessment aids in identifying individuals susceptible to severe COVID-19 outcomes.
Area of Science:
- Genetics
- Epidemiology
- Infectious Disease
Background:
- COVID-19 exhibits varied susceptibility and severity, with disproportionate impacts on UK Black Asian and Minority Ethnic (BAME) groups.
- Genetic factors may explain some of the unexplained variability in COVID-19 outcomes.
- Polygenic Risk Scores (PRS) assess genetic predisposition using Single Nucleotide Polymorphisms (SNPs), but analyses in non-European populations are limited.
Purpose of the Study:
- To apply a multi-ethnic Polygenic Risk Score (PRS) to a UK cohort to investigate the genetic contribution to COVID-19 variability.
- To assess the association between PRS and COVID-19 susceptibility and severity across different ethnic groups.
- To evaluate the utility of PRS in identifying individuals at higher genetic risk for COVID-19.
Main Methods:
- Two PRS were developed for COVID-19 susceptibility and severity based on established risk variants.
- The PRS were applied to 447,382 participants in the UK-Biobank.
- Associations with COVID-19 outcomes were analyzed using logistic regression, with discriminative power assessed by ΔAUC and variance explained by ΔR².
Main Results:
- High genetic risk was significantly associated with increased severe COVID-19 risk in White, Asian, and Black ethnic groups.
- The severity PRS demonstrated strong performance in Asian (ΔAUC 0.9%, ΔR² 0.98%) and Black (ΔAUC 0.6%, ΔR² 0.61%) cohorts.
- For susceptibility, higher genetic risk correlated with infection risk in White individuals but not in Black or Asian groups.
Conclusions:
- Significant associations between PRS and COVID-19 outcomes confirm a genetic basis for disease variability.
- PRS are useful for identifying individuals at high risk for severe COVID-19.
- The multi-ethnic PRS approach is applicable to diverse populations, with the severity model showing promise in Black and Asian cohorts, though larger non-White sample sizes are needed for enhanced statistical power.
Background:
COVID-19 manifests with huge heterogeneity in susceptibility and severity outcomes. UK Black Asian and Minority Ethnic (BAME) groups have demonstrated disproportionate burdens. Some variability remains unexplained, suggesting potential genetic contribution. Polygenic Risk Scores (PRS) can determine genetic predisposition to disease based on Single Nucleotide Polymorphisms (SNPs) within the genome. COVID-19 PRS analyses within non-European samples are extremely limited. We applied a multi-ethnic PRS to a UK-based cohort to understand genetic contribution to COVID-19 variability.
Methods:
We constructed two PRS for susceptibility and severity outcomes based on leading risk-variants from the COVID-19 Host Genetics Initiative. Scores were applied to 447,382 participants from the UK-Biobank. Associations with COVID-19 outcomes were assessed using binary logistic regression and discriminative power was validated using incremental area under receiver operating curve (ΔAUC). Variance explained was compared between ethnic groups via incremental pseudo-R2 (ΔR2).
Results:
Compared to those at low genetic risk, those at high risk had a significantly greater risk of severe COVID-19 for White (odds ratio [OR] 1.57, 95% confidence interval [CI] 1.42-1.74), Asian (OR 2.88, 95% CI 1.63-5.09) and Black (OR 1.98, 95% CI 1.11-3.53) ethnic groups. Severity PRS performed best within Asian (ΔAUC 0.9%, ΔR2 0.98%) and Black (ΔAUC 0.6%, ΔR2 0.61%) cohorts. For susceptibility, higher genetic risk was significantly associated with COVID-19 infection risk for the White cohort (OR 1.31, 95% CI 1.26-1.36), but not for Black or Asian groups.
Conclusions:
Significant associations between PRS and COVID-19 outcomes were elicited, establishing a genetic basis for variability in COVID-19. PRS showed utility in identifying high-risk individuals. The multi-ethnic approach allowed applicability of PRS to diverse populations, with the severity model performing well within Black and Asian cohorts. Further studies with larger sample sizes of non-White samples are required to increase statistical power and better assess impacts within BAME populations.
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