Demographic, Clinical and Immunogenetic Profiles of a Greek Cohort of COVID-19 Patients

Abstract

The present cross-sectional study consists of a comprehensive analysis of epidemiological, laboratory, and clinical characteristics of COVID-19 patients in relation to their immunogenetic profiles. We studied 125 COVID-19 patients comprising different stages of disease severity; non-hospitalized (mild n = 69) and hospitalized (n = 56). Analysis of disease characteristics revealed no major differences between males and females of each group of patients while hospitalized patients were older and presented with comorbidities. A positive allele association was observed for HLA-DRB1*01 in total COVID-19 patients versus healthy controls. Subgrouping of COVID-19 patients in mild and hospitalized further identified a statistically significant increase in HLA-DRB1*01 in mild COVID-19 patients versus controls. The frequency of A*11, A*23, and DRB1*09 alleles was higher, while the frequency of C*12 was lower, in hospitalized patients versus healthy controls albeit with uncorrected statistical significance. The identification of specific allele associations may provide useful future markers for disease susceptibility in order to allow successful clinical management of COVID-19 patients.

HLA Allele Frequencies and Association with Severity of COVID-19 Infection in Northern Italian Patients

“…The protective role of HLA-C*12:02 in SARS-CoV-2 infection is in agreement with a recent report by Detsika MG et al [ 20 ] describing a lower frequency of hospitalised COVID-19 patients carrying the HLA-C*12 allele in a cohort of Greek origin. A putative protective role of HLA-C*12:02 allele was imputed to a high binding affinity with SARS-CoV-2 epitopes, confirming a better host response to the virus [ 14 , 21 ].…”

The association of human leucocyte antigen (HLA) alleles with COVID‐19 severity: A systematic review and meta‐analysis

“…This finding is consistent with the finding of Detsika et al., according to which a higher frequency of HLA‐A*11 carriers was seen in hospitalised than in non‐hospitalised COVID‐19 patients from Greece. 28 Results showing the association of HLA‐A*11 carrier state with COVID‐19 mortality in Spanish patients, 39 as well as with ICU‐admittance in COVID‐19 patients from USA, 47 additionally supported the role of this allelic family in the genetic predisposition to the poor outcome of SARS‐CoV‐2 infection. Still, we could not perform the meta‐analysis for potential association of HLA‐A alleles with the lethal outcome of COVID‐19 for dominant genetic model due to the lack of the corresponding studies.…”

“…In the first two years of extensive research in the area of molecular genetics of COVID‐19, a significant number of association studies related to the disease severity, clinical course and the outcome of SARS‐CoV‐2 infection focused on host polymorphisms in HLA loci. 13 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 These studies were driven by previous results suggesting the involvement of HLA system in the regulation of the immune response to other viruses, as well as by the fine regulation of peptide‐binding properties by the extreme polymorphic feature of HLA loci. 61 , 62 …”

“…Allelic variants belonging to this HLA‐A family were associated with disease severity, need for hospitalisation or ICU admittance, as well as with COVID‐19‐related mortality. 21 , 28 , 30 , 36 , 39 , 47 In their GWAS conducted in the relatively early stage of pandemics in Chinese population, Wang et al. identified HLA‐A*11:01 as a predisposing factor for severe COVID‐19.…”

“…Based on this hypothesis, a relatively large number of studies investigated the role of HLA class I and class II alleles as predictors of COVID‐19 clinical course and the disease outcome. 13 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 However, their results varied significantly, possibly due to the differences in the study designs, severity‐based classification criteria, ethnicity of participants, or other factors with potential confounding effects. The observed heterogeneity between these studies makes it difficult to comprehensively assess the impact of allelic variants on disease severity.…”