Graphical Abstract

Critical illness in COVID-19 is an extreme and clinically homogeneous disease phenotype that we have previously shown1 to be highly efficient for discovery of genetic associations2. Despite the advanced stage of illness at presentation, we have shown that host genetics in patients who are critically ill with COVID-19 can identify immunomodulatory therapies with strong beneficial effects in this group3. Here we analyse 24,202 cases of COVID-19 with critical illness comprising a combination of microarray genotype and whole-genome sequencing data from cases of critical illness in the international GenOMICC (11,440 cases) study, combined with other studies recruiting hospitalized patients with a strong focus on severe and critical disease: ISARIC4C (676 cases) and the SCOURGE consortium (5,934 cases). To put these results in the context of existing work, we conduct a meta-analysis of the new GenOMICC genome-wide association study (GWAS) results with previously published data. We find 49 genome-wide significant associations, of which 16 have not been reported previously. To investigate the therapeutic implications of these findings, we infer the structural consequences of protein-coding variants, and combine our GWAS results with gene expression data using a monocyte transcriptome-wide association study (TWAS) model, as well as gene and protein expression using Mendelian randomization. We identify potentially druggable targets in multiple systems, including inflammatory signalling (JAK1), monocyte–macrophage activation and endothelial permeability (PDE4A), immunometabolism (SLC2A5 and AK5), and host factors required for viral entry and replication (TMPRSS2 and RAB2A).

In the version of this article initially published, the name of Ana Margarita Baldión-Elorza, of the SCOURGE Consortium, appeared incorrectly (as Ana María Baldion) and has now been amended in the HTML and PDF versions of the article.

The impact of coronavirus disease 2019 (COVID-19) pandemic has raised health concerns worldwide. Medical and allied health professional schools are seeking ways to alleviate stress and improve the quality of life among students. The effects of yoga have proven to be successful against stress. The review aimed to examine the psychophysiological effects of yoga on stress management among medical and allied health professional students during COVID-19 pandemic. The authors reviewed existing literature and official documents, which mostly focussed on the effect of yoga among medical and health professional students. Mental stress among these students is known to be higher than that of the general population. Sudden changes due to the pandemic are likely to have a significant impact on these students. Uncertainties concerning teaching, learning and assessment generate stress and anxiety, and social distancing further contributes to loneliness. Yoga has gained recognition not only in improving mental health and quality of life, but it also helps in improving respiratory and immune health. Although many published studies examined the psychophysiological effects of yoga among health professional students; only a few medical and allied health professional schools have incorporated yoga into an integrated curriculum for a holistic approach. In response to the COVID-19 crisis, the use of yoga for stress reduction and immune modulation should be considered as a complement to other treatments. There is a need to integrate yoga into medical and health science curricula to prepare physically fit and mentally sound prospective healthcare professionals.

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