SARS-CoV-2 utilizes the angiotensin-converting enzyme 2 (ACE2) receptor and transmembrane serine protease (TMPRSS2) to infect human lung cells. Previous studies have suggested that different host ACE2 and TMPRSS2 genetic backgrounds might contribute to differences in the rate of SARS-CoV-2 infection or COVID-19 severity. Recent studies have also shown that variants in 15 genes related to type I interferon immunity to influenza virus might predispose patients toward life-threatening COVID-19 pneumonia. Other genes ( SLC6A20, LZTFL1, CCR9, FYCO1, CXCR6, XCR1, IL6, CTSL , ABO , and FURIN ) and HLA alleles have also been implicated in the response to infection with SARS-CoV-2. Currently, Brazil has recorded the third-highest number of COVID-19 cases worldwide. We aimed to investigate the genetic variation present in COVID-19-related genes in the Brazilian population. We analyzed 27 candidate genes and HLA alleles in 954 admixed Brazilian exomes. We used the information available in two public databases ( http://www.bipmed.org and http://abraom.ib.usp.br/ ) and additional exomes from individuals born in southeast Brazil, the region of the country with the highest number of COVID-19 patients. Variant allele frequencies were compared with the 1000 Genomes Project phase 3 (1KGP) and gnomAD databases. We detected 395 nonsynonymous variants; of these, 325 were also found in the 1KGP and/or gnomAD. Six of these variants were previously reported to influence the rate of infection or clinical prognosis of COVID-19. The remaining 70 variants were identified exclusively in the Brazilian sample, with a mean allele frequency of 0.0025. In silico analysis revealed that seven of these variants are predicted to affect protein function. Furthermore, we identified HLA alleles previously associated with the COVID-19 response at loci DQB1 and DRB1 . Our results showed genetic variability common to other populations and rare and ultrarare variants exclusively found in the Brazilian population. These findings might lead to differences in the rate of infection or response to infection by SARS-CoV-2 and should be further investigated in patients with this disease. COVID-19: Variants related to susceptibility in a Brazilian population Genetic variants in the Brazilian population do not appear to explain the relatively high overall rates of COVID-19 cases compared to other countries, but could be relevant for risk assessment at the individual level. Iscia Lopes-Cendes of the University of Campinas and colleagues in Brazil examined gene sequences for variations in 27 genes reported to influence COVID-19 infection in Brazilians of mixed heritage and of people born in the southeast where case numbers are high. These studies included the ACE2 gene that codes for a receptor allowing SARS-CoV-2 to enter host cells. Genetic variants were also identified in two international genome databases. Seventy variants were unique to Brazilians, but computer modeling predicted only seven variants that could affect protein function. The team also looked for and found variants that could affect individual immunity to COVID-19. Similar genetic studies could help identify at-risk individuals and therapeutic targets.
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