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July 15, 2021
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Genetic risk, preexisting COPD may predict risk for severe COVID-19

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High genetic risk and preexisting COPD are both independently associated with increased risk for severe COVID-19, according to data published in the Annals of the American Thoracic Society.

“Although each individual variant only explains a small proportion of severe COVID-19 risk, the combination of many genetic variants into a single polygenic risk score explains a greater proportion of the risk,” Qing-Mei Huang, MPH, from the department of epidemiology in the School of Public Health at Southern Medical University in Guangzhou, Guangdong, and the Longgang Center for Disease Control and Prevention in Shenzhen, China, and colleagues wrote. “Therefore, aggregating multiple single nucleotide polymorphisms to generate a composite polygenic risk score might help explain the genetic risk of polygenic diseases and provide a quantitative measure of the genetic risk.”

Individuals with high genetic risk and preexisting COPD at elevated risk for severe COVID-19 infection
Data was derived Huang QM, et al. Ann Am Thorac Soc. 2021;doi:10.1513/AnnalsATS.202102-171OC.

Researchers constructed a polygenic risk score using 112 single nucleotide polymorphisms to screen for populations at high risk for severe COVID-19. The study included 430,582 participants (mean age, 56.5 years; 55.2% women) from the UK Biobank study. Using logistic regression models, researchers analyzed associations of genetic risk and COPD with the development of severe COVID-19.

In the cohort, 45,648 (10.6%) participants had preexisting COPD. Overall, 712 participants had severe COVID-19 as of February 2021; of those, 19.8% had preexisting COPD.

The researchers reported higher risk for severe COVID-19 infection among participants at intermediate genetic risk (OR = 1.34; 95% CI, 1.09-1.66) and high genetic risk (OR = 1.5; 95% CI, 1.18-1.92) compared with participants at low genetic risk (P = .001). This association was independent of a participant’s COPD diagnosis (P = .76). The association remained in subgroups stratified by age, sex and chronic respiratory infection (P for interaction > .05).

COPD was associated with greater risk for severe COVID-19 infection (OR = 1.37; 95% CI, 1.12-1.67; P = .002).

Those with both high genetic risk and preexisting COPD had greater risk for severe COVID-19 infection (OR = 2.05; 95% CI, 1.35-3.04; P < .001) compared with those at low genetic risk without COPD.

“These findings could have important implications for understanding the mechanisms underlying severe COVID-19 and provide future opportunities for risk stratification and early intervention,” the researchers wrote.