BACKGROUND: Coronavirus disease (COVID-19), which is caused by the SARS-CoV-2 virus, has become a global pandemic. While susceptibility to COVID-19 is subject to several external factors, including hypertension, BMI, and the presence of diabetes, it is also genetically determined to a significant extent. Infectious agents require iron (Fe) for proper functioning. Carriers of mutations resulting in increased iron concentrations are understood to be at increased risk of COVID-19. METHODS: We examined HFE genotypes associated with hereditary haemochromatosis (rs1800562 and rs1799945 SNPs) in 617 COVID-19 patients (166 asymptomatic, 246 symptomatic and 205 hospitalised survivors) and 2 559 population-based controls. RESULTS: We found a higher frequency of the minor allele (Tyr282) of the rs1800562 polymorphism (P < 0.002) in patients compared to controls (8.5 % vs 5.5 %). Non-carriers of the minor allele were protected against SARS-Cov-2 infection (OR, 95 %CI; 0.59, 0.42-0.82). The frequency of minor allele carriers was almost identical across asymptomatic, symptomatic, and hospitalised survivors. The rs1799945 variant did not affect disease severity and its occurrence was almost identical in patients and controls (P between 0.58 and 0.84). CONCLUSIONS: In conclusion, our results indicate that presence of the rs1800562 minor allele, which is associated with hereditary haemochromatosis (thus increased levels of plasma Fe), increases susceptibility to SARS-CoV-2.

Clinic of Rheumatology and Physiotherapy 3rd Faculty of Medicine Charles University and Thomayer University Hospital Prague Czech Republic

Department of Preventive Cardiology Institute for Clinical and Experimental Medicine Prague Czech Republic

Experimental Medicine Centre Institute for Clinical and Experimental Medicine Prague Czech Republic; Department of Endocrinology and Metabolism 3rd Department of Internal Medicine 1st Faculty of Medicine Charles University and General University Hospital Prague Czech Republic

Institute of Health Information and Statistics of the Czech Republic Prague Czech Republic; Institute of Biostatistics and Analyses Faculty of Medicine Masaryk University Brno Czech Republic

Clin Chim Acta. 2023 Mar 1;542:117271. doi: 10.1016/j.cca.2023.117271. PubMed

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ABCA3 and LZTFL1 Polymorphisms and Risk of COVID-19 in the Czech Population

Letter to the editor regarding: "A haemochromatosis-causing HFE mutation is associated with SARS-CoV-2 susceptibility in the Czech population" clinica chimica acta 538 (2023) 211-215