Clinical, regional, and genetic characteristics of Covid-19 patients from UK Biobank.
Clinical, regional, and genetic characteristics of Covid-19 patients from UK Biobank.
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DOI：
10.1371/journal.pone.0241264
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发表时间：
2020
期刊：
影响因子：
3.7
通讯作者：
Elemento O
中科院分区：
文献类型：
--
作者：
Kolin DA;Kulm S;Christos PJ;Elemento O
2019冠状病毒病（COVID-19）已迅速感染全球数百万人。最近的研究表明，少数族裔和患有合并症的患者感染Covid-19的风险更高。在这项研究中，我们分析了临床、地区和遗传因素对Covid-19阳性状态的影响。英国生物库是一项纵向队列研究，从2006年到2010年从英国各地招募参与者。2020年3月16日起，新冠病毒检测结果提供给英国生物样本库。这项研究的主要结果指标是Covid-19阳性状态，由单个个体的任何阳性检测确定。临床风险因素来自英国生物样本库基线，区域风险因素使用每个参与者家庭所在地区的人口普查特征进行估算。我们使用稳健的调整泊松回归与测试实验室的聚类来估计相对风险。使用遗传变异rs 8176719和rs 8176746获得血型，并使用logistic-Firth杂交回归进行全基因组关联测试。这项前瞻性队列研究包括397，064名英国生物库参与者，其中968人的新冠病毒检测呈阳性。与白色受试者相比，黑人受试者的新冠肺炎未校正相对风险为3.66（95% CI 2.83-4.74）。单独调整汤森剥夺指数将相对危险度降低至2.44（95%CI 1.86-3.20）。显著增加Covid-19风险的合并症包括慢性阻塞性肺疾病（调整的相对风险[ARR] 1.64，95% CI 1.18-2.27）、缺血性心脏病（ARR 1.48，95% CI 1.16-1.89）和抑郁症（ARR 1.32，95% CI 1.03-1.70）。有证据表明，血管紧张素转换酶抑制剂（ARR 1.48，95% CI 1.13-1.93）与Covid-19风险增加相关。居住在参与者所在地的总人数的每一个标准差增加都与新冠肺炎风险增加相关（ARR 1.14，95% CI 1.08-1.20）。对遗传推断血型的分析证实，与O型血的参与者相比，A型血的参与者感染Covid-19的几率增加（比值比[OR] 1.16，95%CI 1.01-1.33）。一项跨祖先群体的全基因组关联研究的荟萃分析没有发现任何显著的位点。研究的局限性包括适应症造成的混淆、因早期Covid-19检测结果信息有限而产生的偏倚，以及无法准确衡量疾病严重程度。在评估黑人种族与新冠肺炎的关联时，调整剥夺因素后，新冠肺炎的相对风险降低了33%。在社会学研究的背景下，这些发现表明，劳动力市场的歧视可能在黑人个体的高相对风险中发挥了作用。在这项研究中，我们还证实了A型血与Covid-19以及其他临床和区域因素的相关性。
Coronavirus disease 2019 (Covid-19) has rapidly infected millions of people worldwide. Recent studies suggest that racial minorities and patients with comorbidities are at higher risk of Covid-19. In this study, we analyzed the effects of clinical, regional, and genetic factors on Covid-19 positive status. The UK Biobank is a longitudinal cohort study that recruited participants from 2006 to 2010 from throughout the United Kingdom. Covid-19 test results were provided to UK Biobank starting on March 16, 2020. The main outcome measure in this study was Covid-19 positive status, determined by the presence of any positive test for a single individual. Clinical risk factors were derived from UK Biobank at baseline, and regional risk factors were imputed using census features local to each participant’s home zone. We used robust adjusted Poisson regression with clustering by testing laboratory to estimate relative risk. Blood types were derived using genetic variants rs8176719 and rs8176746, and genomewide tests of association were conducted using logistic-Firth hybrid regression. This prospective cohort study included 397,064 UK Biobank participants, of whom 968 tested positive for Covid-19. The unadjusted relative risk of Covid-19 for Black participants was 3.66 (95% CI 2.83–4.74), compared to White participants. Adjusting for Townsend deprivation index alone reduced the relative risk to 2.44 (95% CI 1.86–3.20). Comorbidities that significantly increased Covid-19 risk included chronic obstructive pulmonary disease (adjusted relative risk [ARR] 1.64, 95% CI 1.18–2.27), ischemic heart disease (ARR 1.48, 95% CI 1.16–1.89), and depression (ARR 1.32, 95% CI 1.03–1.70). There was some evidence that angiotensin converting enzyme inhibitors (ARR 1.48, 95% CI 1.13–1.93) were associated with increased risk of Covid-19. Each standard deviation increase in the number of total individuals living in a participant’s locality was associated with increased risk of Covid-19 (ARR 1.14, 95% CI 1.08–1.20). Analyses of genetically inferred blood types confirmed that participants with type A blood had increased odds of Covid-19 compared to participants with type O blood (odds ratio [OR] 1.16, 95% CI 1.01–1.33). A meta-analysis of genomewide association studies across ancestry groups did not reveal any significant loci. Study limitations include confounding by indication, bias due to limited information on early Covid-19 test results, and inability to accurately gauge disease severity. When assessing the association of Black race with Covid-19, adjusting for deprivation reduced the relative risk of Covid-19 by 33%. In the context of sociological research, these findings suggest that discrimination in the labor market may play a role in the high relative risk of Covid-19 for Black individuals. In this study, we also confirmed the association of blood type A with Covid-19, among other clinical and regional factors.
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影响因子：
3.7
作者：
Benetti E;Giliberti A;Emiliozzi A;Valentino F;Bergantini L;Fallerini C;Anedda F;Amitrano S;Conticini E;Tita R;d'Alessandro M;Fava F;Marcantonio S;Baldassarri M;Bruttini M;Mazzei MA;Montagnani F;Mandalà M;Bargagli E;Furini S;GEN-COVID Multicenter Study;Renieri A;Mari F
通讯作者：
Mari F
影响因子：
9.3
作者：
Niedzwiedz, Claire L.;O'Donnell, Kate A.;Katikireddi, S. Vittal
通讯作者：
Katikireddi, S. Vittal
影响因子：
9.2
作者：
Chang CC;Chow CC;Tellier LC;Vattikuti S;Purcell SM;Lee JJ
通讯作者：
Lee JJ
影响因子：
4.3
作者：
Dilthey, Alexander;Leslie, Stephen;McVean, Gil
通讯作者：
McVean, Gil
影响因子：
33.9
作者：
Dyal, Jonathan W.;Grant, Michael P.;Honein, Margaret A.
通讯作者：
Honein, Margaret A.