Department of Medical Sciences, University of Turin, Turin, Italy.
Immunogenetics and Transplant Biology, Azienda Ospedaliera Universitaria Città della Salute e della Scienza di Torino, Turin, Italy.
Transplantation. 2021 Jan 1;105(1):193-200. doi: 10.1097/TP.0000000000003507.
SARS-CoV-2 infection is heterogeneous in clinical presentation and disease evolution. To investigate whether immune response to the virus can be influenced by genetic factors, we compared HLA and AB0 frequencies in organ transplant recipients and waitlisted patients according to presence or absence of SARS-CoV-2 infection.
A retrospective analysis was performed on an Italian cohort composed by transplanted and waitlisted patients in a January 2002 to March 2020 time frame. Data from this cohort were merged with the Italian registry of COVID+ subjects, evaluating infection status of transplanted and waitlisted patients. A total of 56 304 cases were studied with the aim of comparing HLA and AB0 frequencies according to the presence (n = 265, COVID+) or absence (n = 56 039, COVID-) of SARS-CoV-2 infection.
The cumulative incidence rate of COVID-19 was 0.112% in the Italian population and 0.462% in waitlisted/transplanted patients (OR = 4.2; 95% CI, 3.7-4.7; P < 0.0001). HLA-DRB108 was more frequent in COVID+ (9.7% and 5.2%: OR = 1.9, 95% CI, 1.2-3.1; P = 0.003; Pc = 0.036). In COVID+ patients, HLA-DRB108 was correlated to mortality (6.9% in living versus 17.5% in deceased: OR = 2.9, 95% CI, 1.15-7.21; P = 0.023). Peptide binding prediction analyses showed that these DRB1*08 alleles were unable to bind any of the viral peptides with high affinity. Finally, blood group A was more frequent in COVID+ (45.5%) than COVID- patients (39.0%; OR = 1.3; 95% CI, 1.02-1.66; P = 0.03).
Although preliminary, these results suggest that HLA antigens may influence SARS-CoV-2 infection and clinical evolution of COVID-19 and confirm that blood group A individuals are at greater risk of infection, providing clues on the spread of the disease and indications about infection prognosis and vaccination strategies.
SARS-CoV-2 感染在临床表现和疾病进展方面存在异质性。为了研究病毒的免疫反应是否受遗传因素的影响，我们根据 SARS-CoV-2 感染的存在与否，比较了器官移植受者和候补患者的 HLA 和 ABO 频率。
对 2002 年 1 月至 2020 年 3 月期间组成的意大利队列中的移植受者和候补患者进行了回顾性分析。合并了该队列与意大利 COVID+受试者登记处的数据，评估了移植受者和候补患者的感染状态。共研究了 56304 例患者，目的是根据 SARS-CoV-2 感染的存在（n=265，COVID+）或不存在（n=56304，COVID-）比较 HLA 和 ABO 频率。
意大利人群 COVID-19 的累积发病率为 0.112%，候补/移植患者为 0.462%（OR=4.2；95%CI，3.7-4.7；P<0.0001）。COVID+中 HLA-DRB108 更为常见（9.7%和 5.2%：OR=1.9，95%CI，1.2-3.1；P=0.003；Pc=0.036）。在 COVID+患者中，HLA-DRB108 与死亡率相关（存活患者中为 6.9%，死亡患者中为 17.5%：OR=2.9，95%CI，1.15-7.21；P=0.023）。肽结合预测分析表明，这些 DRB1*08 等位基因无法与任何高亲和力的病毒肽结合。最后，ABO 血型 A 在 COVID+（45.5%）中比 COVID-患者（39.0%）更为常见（OR=1.3；95%CI，1.02-1.66；P=0.03）。
尽管初步，但这些结果表明 HLA 抗原可能影响 SARS-CoV-2 感染和 COVID-19 的临床演变，并证实血型 A 个体感染风险更高，为疾病传播提供线索，并为感染预后和疫苗接种策略提供依据。
