ABSTRACT
COVID-19 has caused numerous infections with diverse clinical symptoms. To identify human genetic variants contributing to the clinical development of COVID-19, we genotyped 1457 (598/859 with severe/mild symptoms) and sequenced 1141 (severe/mild: 474/667) patients of Chinese ancestry. We further incorporated 1401 genotyped and 948 sequenced ancestry-matched population controls, and tested genome-wide association on 1072 severe cases versus 3875 mild or population controls, followed by trans-ethnic meta-analysis with summary statistics of 3199 hospitalized cases and 897,488 population controls from the COVID-19 Host Genetics Initiative. We identified three significant signals outside the well-established 3p21.31 locus: an intronic variant in FOXP4-AS1 (rs1853837, odds ratio OR = 1.28, P = 2.51 × 10-10, allele frequencies in Chinese/European AF = 0.345/0.105), a frameshift insertion in ABO (rs8176719, OR = 1.19, P = 8.98 × 10-9, AF = 0.422/0.395) and a Chinese-specific intronic variant in MEF2B (rs74490654, OR = 8.73, P = 1.22 × 10-8, AF = 0.004/0). These findings highlight an important role of the adaptive immunity and the ABO blood-group system in protection from developing severe COVID-19.
Subject(s)
COVID-19/ethnology , COVID-19/genetics , Ethnicity/genetics , Genome-Wide Association Study , Genetic Predisposition to Disease/genetics , Humans , Introns/genetics , Polymorphism, Single NucleotideSubject(s)
Antigens, Fungal/blood , Coronavirus Infections/blood , Mycoses/blood , Pneumonia, Viral/blood , Adult , Aged , Betacoronavirus , COVID-19 , Coinfection , Coronavirus Infections/epidemiology , Coronavirus Infections/pathology , Humans , Middle Aged , Mycoses/epidemiology , Mycoses/pathology , Pandemics , Pneumonia, Viral/epidemiology , Pneumonia, Viral/pathology , Retrospective Studies , SARS-CoV-2 , Young AdultSubject(s)
Extracorporeal Membrane Oxygenation , Betacoronavirus , COVID-19 , China , Coronavirus Infections , Critical Illness , Humans , Pandemics , Pneumonia, Viral , Prognosis , Retrospective Studies , SARS-CoV-2ABSTRACT
OBJECTIVE: To provide clinical management guidelines for novel coronavirus (COVID-19) in pregnancy. METHODS: On February 5, 2020, a multidisciplinary teleconference comprising Chinese physicians and researchers was held and medical management strategies of COVID-19 infection in pregnancy were discussed. RESULTS: Ten key recommendations were provided for the management of COVID-19 infections in pregnancy. CONCLUSION: Currently, there is no clear evidence regarding optimal delivery timing, the safety of vaginal delivery, or whether cesarean delivery prevents vertical transmission at the time of delivery; therefore, route of delivery and delivery timing should be individualized based on obstetrical indications and maternal-fetal status.