Background. The role for the HLA complex in SARS-CoV-2 immunosurveillance, resistance to virus infection and type of the individual immune response is accounted for by the extraordinary variability of HLA-genotypes as well as involvement of HLA-molecules in the mechanisms behind both cellular and humoral immunity. The aim of our study was to identify HLA-genetic factors underling severe COVID-19 course in St. Petersburg residents. Materials and methods. The study included 78 St. Petersburg residents aged 20 to 84 years (median — 55 years) recovered after COVID-19 in 2020–2022. The distribution of the examined persons based on COVID-19 severity was as follows: mild — 41, moderate — 32, severe — 5 persons. For further analysis, subjects with moderate-to-severe disease were included into a single group (37 persons). The control group consisted of 1.563 St. Petersburg residents who were potential hematopoietic stem cell donors, aged 18 to 60 years (median — 32 years). The low resolution HLA typing was performed by polymerase chain reaction using sequence-specific primers and sequence-specific oligonucleotide probes. HLA typing in control group was performed prior to SARS-CoV-2 pandemic. Results. A lower frequency of HLA-A*01 group was found in individuals with mild vs moderate/severe COVID-19 (0.0366 vs 0.1351; p = 0.04) and control group (0.0366 vs 0.1193; p = 0.02). A higher frequency of HLA-A*11 group was found in moderate/severe course compared to mild COVID-19 (0.1081 vs 0.0244; p = 0.048). Compared to control group, HLA-A*11 frequency in moderate/severe course (0.1081 vs 0.0582; p = 0.08) tended to increase. According to multivariate analysis, the risk of severe COVID-19 course in St. Petersburg residents was significantly associated with detected HLA-A*11 allele group (OR 7.38; CI 1.15–47.3; p = 0.032) and age (OR 1.05; CI 1.01–1.09; p = 0.008) along with an effect from HLA-A*01 tending to contribute to a risk of developing severe COVID-19 (OR 3.88; CI 0.88–17.09; p = 0.068). Conclusion. HLA markers for severe COVID-19 in St. Petersburg residents was identified providing deeper insight into a role played by HLA system in COVID-19 outcomes.
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