ABSTRACT
Sex-biased difference in coronavirus disease 2019 (COVID-19) hospitalization has been observed as that male patients tend to be more likely to be hospitalized than female patients. However, due to the insufficient sample size and existed studies that more prioritized to sex-stratified COVID-19 genome-wide association study (GWAS), the searching for sex-biased genetic variants showing differential association signals between sexes with COVID-19 hospitalization was severely hindered. We hypothesized genetic variants would show potentially sex-biased genetic effects on COVID-19 hospitalization if they display significant differential association effect sizes between male and female COVID-19 patients. By integrating two COVID-19 GWASs, including hospitalized COVID-19 patients vs. general population separated into males (case = 1,917 and control = 221,174) and females (case = 1,343 and control = 262,886), we differentiated the association effect sizes of each common single nucleotide polymorphism (SNP) within the two GWASs. Twelve SNPs were suggested to show differential COVID-19 associations between sexes. Further investigation of genes (n = 58) close to these 12 SNPs resulted in the identification of 34 genes demonstrating sex-biased differential expression in at least one GTEx tissue. Finally, 5 SNPs are mapped to 8 genes, including rs1134004 (GADD45G), rs140657166 (TRIM29 and PVRL1), rs148143613 (KNDC1 and STK32C), rs2443615 (PGAP2 and TRIM21), and rs2924725 (CSMD1). The 8 genes display significantly differential gene expression in blood samples derived from COVID-19 patients compared to healthy controls. These genes are potential genetic factors contributing to sex differences in COVID-19 hospitalization and warranted for further functional studies.
ABSTRACT
Higher body mass index (BMI) has been associated with a higher risk for severe COVID-19 outcomes. The aim of this study was to investigate associations among BMI, underlying health conditions and hospital admission as well as the effects of COVID-19 vaccines in adults aged 50 years and older in Europe using data from the Survey of Health, Ageing and Retirement in Europe (SHARE) which was collected from June to August 2021, shortly after the second wave of the COVID-19 pandemic occurred in Europe. Survey data totalling 1936 individuals were used for statistical analyses to calculate the likelihood of hospitalization due to COVID-19 infection in relation to BMI, sociodemographic factors, comorbidities and COVID vaccination status. Approximately 16% of individuals testing positive for COVID-19 were hospitalized for COVID-19, and over 75% of these hospitalized individuals were either overweight or obese. The likelihood of hospitalization for individuals with obesity was approximately 1.5 times (CI [1.05-2.05]) higher than those with a healthy weight (BMI = 18.5-24.9 kg/m2) after adjusting for BMI, sex and age. After adjusting for sociodemographic factors, vaccination and comorbidities, the likelihood of hospitalization for individuals with obesity was 1.34 times higher than those with a healthy weight (CI [0.94-1.90]). Vaccine uptake was lowest in individuals with obesity (BMI ≥ 30 kg/m2) in all age groups. Individuals who had not received a vaccine were 1.8 times more likely to be hospitalized (CI [1.34-2.30]). Across European regions, obesity is associated with higher odds of hospitalization, and vaccination may be effective to reduce these odds for older adults.