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Fischer JC, Schmidt AG, Bölke E, Uhrberg M, Keitel V, Feldt T, Jensen B, Häussinger D, Adams O, Schneider EM, Balz V, Enczmann J, Rox J, Hermsen D, Schulze-Bosse K, Kindgen-Milles D, Knoefel WT, van Griensven M, Haussmann J, Tamaskovics B, Plettenberg C, Scheckenbach K, Corradini S, Pedoto A, Maas K, Schmidt L, Grebe O, Esposito I, Ehrhardt A, Peiper M, Buhren BA, Calles C, Stöhr A, Lichtenberg A, Freise NF, Lutterbeck M, Rezazadeh A, Budach W, Matuschek C. Association of HLA genotypes, AB0 blood type and chemokine receptor 5 mutant CD195 with the clinical course of COVID-19. Eur J Med Res 2021; 26:107. [PMID: 34530915 PMCID: PMC8444184 DOI: 10.1186/s40001-021-00560-4] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2021] [Accepted: 07/23/2021] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND COVID-19, the pandemic disease caused by infection with SARS-CoV-2, may take highly variable clinical courses, ranging from symptom-free and pauci-symptomatic to fatal disease. The goal of the current study was to assess the association of COVID-19 clinical courses controlled by patients' adaptive immune responses without progression to severe disease with patients' Human Leukocyte Antigen (HLA) genetics, AB0 blood group antigens, and the presence or absence of near-loss-of-function delta 32 deletion mutant of the C-C chemokine receptor type 5 (CCR5). PATIENT AND METHODS An exploratory observational study including 157 adult COVID-19 convalescent patients was performed with a median follow-up of 250 days. The impact of different HLA genotypes, AB0 blood group antigens, and the CCR5 mutant CD195 were investigated for their role in the clinical course of COVID-19. In addition, this study addressed levels of severity and morbidity of COVID-19. The association of the immunogenetic background parameters were further related to patients' humoral antiviral immune response patterns by longitudinal observation. RESULTS Univariate HLA analyses identified putatively protective HLA alleles (HLA class II DRB1*01:01 and HLA class I B*35:01, with a trend for DRB1*03:01). They were associated with reduced durations of disease instead decreased (rather than increased) total anti-S IgG levels. They had a higher virus neutralizing capacity compared to non-carriers. Conversely, analyses also identified HLA alleles (HLA class II DQB1*03:02 und HLA class I B*15:01) not associated with such benefit in the patient cohort of this study. Hierarchical testing by Cox regression analyses confirmed the significance of the protective effect of the HLA alleles identified (when assessed in composite) in terms of disease duration, whereas AB0 blood group antigen heterozygosity was found to be significantly associated with disease severity (rather than duration) in our cohort. A suggestive association of a heterozygous CCR5 delta 32 mutation status with prolonged disease duration was implied by univariate analyses but could not be confirmed by hierarchical multivariate testing. CONCLUSION The current study shows that the presence of HLA class II DRB1*01:01 and HLA class I B*35:01 is of even stronger association with reduced disease duration in mild and moderate COVID-19 than age or any other potential risk factor assessed. Prospective studies in larger patient populations also including novel SARS-CoV-2 variants will be required to assess the impact of HLA genetics on the capacity of mounting protective vaccination responses in the future.
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Affiliation(s)
- Johannes C Fischer
- Institute for Transplantation Diagnostics and Cell Therapeutics, University Hospital Dusseldorf, Medical Faculty, Heinrich-Heine-University, 40225, Dusseldorf, Germany
| | - Albrecht G Schmidt
- Department of Radiation Oncology, University Hospital Dusseldorf, Medical Faculty, Heinrich-Heine-University Dusseldorf, Moorenstr. 5, 40225, Dusseldorf, Germany
| | - Edwin Bölke
- Department of Radiation Oncology, University Hospital Dusseldorf, Medical Faculty, Heinrich-Heine-University Dusseldorf, Moorenstr. 5, 40225, Dusseldorf, Germany.
| | - Markus Uhrberg
- Institute for Transplantation Diagnostics and Cell Therapeutics, University Hospital Dusseldorf, Medical Faculty, Heinrich-Heine-University, 40225, Dusseldorf, Germany
| | - Verena Keitel
- Department of Gastroenterology, Hepatology and Infectious Diseases, University Hospital Dusseldorf, Medical Faculty, Heinrich-Heine-University Dusseldorf, Moorenstr. 5, 40225, Dusseldorf, Germany
| | - Torsten Feldt
- Department of Gastroenterology, Hepatology and Infectious Diseases, University Hospital Dusseldorf, Medical Faculty, Heinrich-Heine-University Dusseldorf, Moorenstr. 5, 40225, Dusseldorf, Germany
| | - Björn Jensen
- Department of Gastroenterology, Hepatology and Infectious Diseases, University Hospital Dusseldorf, Medical Faculty, Heinrich-Heine-University Dusseldorf, Moorenstr. 5, 40225, Dusseldorf, Germany
| | - Dieter Häussinger
- Department of Gastroenterology, Hepatology and Infectious Diseases, University Hospital Dusseldorf, Medical Faculty, Heinrich-Heine-University Dusseldorf, Moorenstr. 5, 40225, Dusseldorf, Germany
| | - Ortwin Adams
- Institute for Virology, University Hospital Dusseldorf, Medical Faculty, Heinrich-Heine-University Dusseldorf, Universitaetsstr. 1, 40225, Dusseldorf, Germany
| | - E Marion Schneider
- Division of Experimental Anesthesiology, University Hospital Ulm, Ulm, Germany
| | - Vera Balz
- Institute for Transplantation Diagnostics and Cell Therapeutics, University Hospital Dusseldorf, Medical Faculty, Heinrich-Heine-University, 40225, Dusseldorf, Germany
| | - Jürgen Enczmann
- Institute for Transplantation Diagnostics and Cell Therapeutics, University Hospital Dusseldorf, Medical Faculty, Heinrich-Heine-University, 40225, Dusseldorf, Germany
| | - Jutta Rox
- Institute for Transplantation Diagnostics and Cell Therapeutics, University Hospital Dusseldorf, Medical Faculty, Heinrich-Heine-University, 40225, Dusseldorf, Germany
| | - Derik Hermsen
- Central Institute for Laboratory Diagnostics and Clinical Chemistry, Medical Faculty Heinrich-Heine University, Dusseldorf, Germany
| | - Karin Schulze-Bosse
- Central Institute for Laboratory Diagnostics and Clinical Chemistry, Medical Faculty Heinrich-Heine University, Dusseldorf, Germany
| | - Detlef Kindgen-Milles
- Medical Faculty, Department of Anesthesiology, Heinrich Heine University, Dusseldorf, Germany
| | - Wolfram Trudo Knoefel
- Medical Faculty, Department of Surgery and Interdisciplinary Surgical Intensive Care Unit, Heinrich Heine University, Dusseldorf, Germany
| | - Martijn van Griensven
- Department cBITE, Maastricht University, MERLN Institute for Technology-Inspired Regenerative Medicine, Maastricht, the Netherlands
| | - Jan Haussmann
- Department of Radiation Oncology, University Hospital Dusseldorf, Medical Faculty, Heinrich-Heine-University Dusseldorf, Moorenstr. 5, 40225, Dusseldorf, Germany
| | - Balint Tamaskovics
- Department of Radiation Oncology, University Hospital Dusseldorf, Medical Faculty, Heinrich-Heine-University Dusseldorf, Moorenstr. 5, 40225, Dusseldorf, Germany
| | - Christian Plettenberg
- Medical Faculty, Department of Ear, Nose and Throat Disease, Heinrich Heine University, Dusseldorf, Germany
| | - Kathrin Scheckenbach
- Medical Faculty, Department of Ear, Nose and Throat Disease, Heinrich Heine University, Dusseldorf, Germany
| | - Stefanie Corradini
- Department of Radiation Oncology, University Hospital, LMU Munich, Munich, Germany
| | - Alessia Pedoto
- Department of Anesthesiology, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Kitti Maas
- Department of Radiation Oncology, University Hospital Dusseldorf, Medical Faculty, Heinrich-Heine-University Dusseldorf, Moorenstr. 5, 40225, Dusseldorf, Germany
| | - Livia Schmidt
- Department of Radiation Oncology, University Hospital Dusseldorf, Medical Faculty, Heinrich-Heine-University Dusseldorf, Moorenstr. 5, 40225, Dusseldorf, Germany
| | - Olaf Grebe
- Department of Cardiology and Rhythmology, Petrus Hospital, Wuppertal, Germany
| | - Irene Esposito
- Institute of Pathology, University of Dusseldorf, Dusseldorf, Germany
| | - Anja Ehrhardt
- Institute of Virology, University of Witten/Herdecke, Witten, Germany
| | - Matthias Peiper
- Medical Faculty, University of Dusseldorf, Dusseldorf, Germany
| | - Bettina Alexandra Buhren
- Department of Radiation Oncology, University Hospital Dusseldorf, Medical Faculty, Heinrich-Heine-University Dusseldorf, Moorenstr. 5, 40225, Dusseldorf, Germany
| | - Christian Calles
- Medical Faculty, Coordination Center for Clinical Studies, University of Dusseldorf, Dusseldorf, Germany
| | - Andreas Stöhr
- Medical Faculty, Coordination Center for Clinical Studies, University of Dusseldorf, Dusseldorf, Germany
| | - Artur Lichtenberg
- Department of Cardiac Surgery, Medical Faculty, University of Dusseldorf, Dusseldorf, Germany
| | - Noemi F Freise
- Department of Gastroenterology, Hepatology and Infectious Diseases, University Hospital Dusseldorf, Medical Faculty, Heinrich-Heine-University Dusseldorf, Moorenstr. 5, 40225, Dusseldorf, Germany
| | - Matthias Lutterbeck
- Department of Gastroenterology, Hepatology and Infectious Diseases, University Hospital Dusseldorf, Medical Faculty, Heinrich-Heine-University Dusseldorf, Moorenstr. 5, 40225, Dusseldorf, Germany
| | - Amir Rezazadeh
- Department of Radiation Oncology, University Hospital Dusseldorf, Medical Faculty, Heinrich-Heine-University Dusseldorf, Moorenstr. 5, 40225, Dusseldorf, Germany
| | - Wilfried Budach
- Department of Radiation Oncology, University Hospital Dusseldorf, Medical Faculty, Heinrich-Heine-University Dusseldorf, Moorenstr. 5, 40225, Dusseldorf, Germany
| | - Christiane Matuschek
- Department of Radiation Oncology, University Hospital Dusseldorf, Medical Faculty, Heinrich-Heine-University Dusseldorf, Moorenstr. 5, 40225, Dusseldorf, Germany
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