HLA genetic polymorphisms and prognosis of patients with COVID-19
L Lorente1, M M Martín2, A Franco3
1Intensive Care Unit, Hospital Universitario de Canarias, Ofra, s/n., La Laguna 38320, Santa Cruz de Tenerife, Spain.
Insights
Human leukocyte antigen (HLA) genetic variations may influence coronavirus disease 2019 (COVID-19) mortality. Specific HLA alleles were associated with increased mortality risk in COVID-19 patients, warranting further investigation with larger cohorts.
Area of Science:
- Immunogenetics
- Infectious Disease Epidemiology
Background:
- Human leukocyte antigen (HLA) genetic polymorphisms are linked to autoimmune and infectious disease outcomes.
- Understanding HLA associations with COVID-19 is crucial for prognosis and risk stratification.
Purpose of the Study:
- To investigate the association between HLA genetic polymorphisms and COVID-19 susceptibility and mortality.
- To identify specific HLA alleles that may predict mortality in critically ill COVID-19 patients.
Main Methods:
- Prospective observational study involving 72 COVID-19 patients and 3886 healthy controls.
- Determination of HLA genetic polymorphisms.
- Logistic regression analysis to assess the association between HLA alleles and 30-day mortality, controlling for severity scores (SOFA, APACHE-II).
Main Results:
- A trend suggested differences in certain HLA alleles between COVID-19 patients and healthy controls, though not statistically significant after multiple comparison correction.
- Logistic regression identified associations between specific HLA alleles (HLA-A*11, HLA-C*01, HLA-DQB1*04) and increased 30-day mortality in COVID-19 patients, even after adjusting for disease severity.
Conclusions:
- Preliminary findings suggest a potential link between HLA genetic polymorphisms and COVID-19 mortality.
- Larger-scale studies are necessary to confirm these associations and draw definitive conclusions regarding the role of HLA in COVID-19 outcomes.
Objective:
Different genetic polymorphisms of human leukocyte antigen (HLA) have been associated with the risk and prognosis of autoimmune and infectious diseases. The objectives of this study were to determine whether there is an association between HLA genetic polymorphisms and the susceptibility to and mortality of coronavirus disease 2019 (COVID-19) patients.
Design:
Observational and prospective study.
Setting:
Eight Intensive Care Units (ICU) from 6 hospitals of Canary Islands (Spain).
Patients:
COVID-19 patients admitted in ICU and healthy subjects.
Interventions:
Determination of HLA genetic polymorphisms.
Main Variable Of Interest:
Mortality at 30 days.
Results:
A total of 3886 healthy controls and 72 COVID-19 patients (10 non-survivors and 62 survivor patients at 30 days) were included. We found a trend to a higher rate of the alleles HLA-A*32 (p = 0.004) in healthy controls than in COVID-19 patients, and of the alleles HLA-B*39 (p = 0.02) and HLA-C*16 (p = 0.02) in COVID-19 patients than in healthy controls; however, all these p-values were not significant after correction for multiple comparisons. Logistic regression analysis showed that the presence of certain alleles was associated with higher mortality, such as the allele HLA-A*11 after controlling for SOFA (OR = 7.693; 95% CI = 1.063-55.650; p = 0.04) or APACHE-II (OR = 11.858; 95% CI = 1.524-92.273; p = 0.02), the allele HLA-C*01 after controlling for SOFA (OR = 11.182; 95% CI = 1.053-118.700; p = 0.04) or APACHE-II (OR = 17.604; 95% CI = 1.629-190.211; p = 0.02), and the allele HLA-DQB1*04 after controlling for SOFA (OR = 9.963; 95% CI = 1.235-80.358; p = 0.03).
Conclusions:
The new finding from our preliminary study of small sample size was that HLA genetic polymorphisms could be associated with COVID-19 mortality; however, studies with a larger sample size before definitive conclusions can be drawn.
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