Genome-Wide Association Study of COVID-19 Outcomes Reveals Novel Host Genetic Risk Loci in the Serbian Population

Host genetics, an important contributor to the COVID-19 clinical susceptibility and severity, currently is the focus of multiple genome-wide association studies (GWAS) in populations affected by the pandemic. This is the first study from Serbia that performed a GWAS of COVID-19 outcomes to identify genetic risk markers of disease severity. A group of 128 hospitalized COVID-19 patients from the Serbian population was enrolled in the study. We conducted a GWAS comparing (1) patients with pneumonia ( n = 80) against patients without pneumonia ( n = 48), and (2) severe ( n = 34) against mild disease ( n = 48) patients, using a genotyping array followed by imputation of missing genotypes. We have detected a significant signal associated with COVID-19 related pneumonia at locus 13q21.33, with a peak residing upstream of the gene KLHL1 ( p = 1.91 × 10 −8 ). Our study also replicated a previously reported COVID-19 risk locus at 3p21.31, identifying lead variants in SACM1L and LZTFL1 genes suggestively associated with pneumonia ( p = 7.54 × 10 −6 ) and severe COVID-19 ( p = 6.88 × 10 −7 ), respectively. Suggestive association with COVID-19 pneumonia has also been observed at chromosomes 5p15.33 ( IRX, NDUFS6, MRPL36, p = 2.81 × 10 −6 ), 5q11.2 ( ESM1, p = 6.59 × 10 −6 ), and 9p23 ( TYRP1, LURAP1L , p = 8.69 × 10 −6 ). The genes located in or near the risk loci are expressed in neural or lung tissues, and have been previously associated with respiratory diseases such as asthma and COVID-19 or reported as differentially expressed in COVID-19 gene expression profiling studies. Our results revealed novel risk loci for pneumonia and severe COVID-19 disease which could contribute to a better understanding of the COVID-19 host genetics in different populations.