ABSTRACT
To elucidate the host genetic loci affecting severity of SARS-CoV-2 infection, or Coronavirus disease 2019 (COVID-19), is an emerging issue in the face of the current devastating pandemic. Here, we report a genome-wide association study (GWAS) of COVID-19 in a Japanese population led by the Japan COVID-19 Task Force, as one of the initial discovery GWAS studies performed on a non-European population. Enrolling a total of 2,393 cases and 3,289 controls, we not only replicated previously reported COVID-19 risk variants (e.g., LZTFL1, FOXP4, ABO, and IFNAR2), but also found a variant on 5q35 (rs60200309-A at DOCK2) that was associated with severe COVID-19 in younger (<65 years of age) patients with a genome-wide significant p-value of 1.2 x 10-8 (odds ratio = 2.01, 95% confidence interval = 1.58-2.55). This risk allele was prevalent in East Asians, including Japanese (minor allele frequency [MAF] = 0.097), but rarely found in Europeans. Cross-population Mendelian randomization analysis made a causal inference of a number of complex human traits on COVID-19. In particular, obesity had a significant impact on severe COVID-19. The presence of the population-specific risk allele underscores the need of non-European studies of COVID-19 host genetics.
ABSTRACT
The patient was a 81-year-old woman, who had been carried into our hospital after having been hit by a small truck. The accident occurred when she was crossing a street. Her major complaints were gross hematuria and left abdominal pain. Computerized tomography was performed with contrast medium. In light of the Japanese classification of renal trauma, we diagnosed the case as Type IIIb kidney trauma, which is characterized by deep renal injury in the middle of the kidney. The patient was treated conservatively. Her condition was stable. However, on the 18th day after the traffic accident, hematuria recurred all of a sudden.As anemia progressed, erythrocyte transfusion was done. Radiographs of the arteries in the injured left kidney revealed arteriovenous fistula and psuedoaneurysm. Because of these findings, transcatheter arterial embolism (TAE) was performed using liquid embolic material and a microcoil. After surgery, hematuria ceased and anemia abated. The patient was doing fine for a while. But she suffered from cardiac insufficiency and had to undergo long-term internal treatment. Now, 14 months have elapsed since she met with the accident. There are no recurrence of arteriovenous fistula, no occurrence of renal infarction and no sign of decreased renal functions. This indicates that our TAE operation has been a success. Since there are reports that renal arteriovenous fistula is complicated by cardiovascular diseases, careful watch must be kept on these complications during the long-term management of patients with this type of renal disorder.