The SARS-CoV-2 virus does not affect everyone in the same way. Some groups seem particularly vulnerable to severe COVID-19, notably the elderly and those with existing health conditions. In addition, there are those who do not seem to fall into any particular risk category, including those who are young and otherwise healthy, yet become catastrophically ill. Variation in susceptibility to infectious disease and its consequences depends on social, economic, and environmental factors, but also genetic differences. Apparent familial or heritable variations in susceptibility to disease have long been recognized, for example in relation to tuberculosis, malaria, leprosy, and HIV, and preliminary reports are emerging in relation to COVID-19.1,2
Host genomic information may facilitate stratification and targeting of care and vaccination, and enable the identification of people who may be at higher risk of harm. Genetic information might also enable targeting therapeutic interventions to those more likely to develop severe illness or protecting them from adverse reactions. Information from those less susceptible to infection with SARS-CoV-2 may be valuable in identifying potential therapies.
The scientific community has acted rapidly to establish the COVID-19 Host Genetics initiative, which includes 127 studies in a global collaboration to investigate the genomes of those infected by coronavirus.3 The rapid move to collaborate, collect, and share host genomic data is supported by efforts to work through ethical and legal challenges associated with the international sharing of genomic and health data. Leading commercial genetic companies have also launched studies of COVID-19 susceptibility, drawing on their substantial privately held data sets. This commentary highlights the need for COVID-19 host genetics to engage with questions related to the role of genetic susceptibility factors in creating potential inequalities in the ability to work or access public space, stigma, and inequalities in the quality and scope of data.
Milne R (2020) Societal considerations in host genome testing for COVID-19. Genetics in Medicine. Published online ahead of print, 8 June