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The World Health Organization (WHO) declared the outbreak of this novel Coronavirus as a Global pandemic on 12th March 2020.

Caused by a virus named SARS-CoV-2 (formerly known as 2019-nCoV), this is the deadliest pandemic the world has seen since the Spanish influenza of 1918.

As of July 2020, COVID-19 is still continuing its fateful march around the globe.

Why do the symptoms vary? 

In most cases, COVID-19 starts out as flu-like symptoms, and a little over 70% of the people recover on their own.

But occasionally, (if you have to put a number on it, around 1 in 6) breathing difficulty and other respiratory issues occur.

In extreme cases, COVID-19 positive individuals can be asymptomatic.  

Initial research that explored the broader spectrum of things suggests that age, gender, geographic location, and underlying health conditions may all influence the severity and susceptibility to COVID-19.

To gain more clarity, GWAS studies, and other small sample size research studies were conducted on the genetic contribution to the varying symptoms.

Here’s what we know so far:

COVID severity 

Research studies have shown that genetic variants associated with host cell entry, production of cytokines, and immune response have a link to the severity of the infection.

The study confirmed the importance of ACE gene expression and the HLA region in the host response to viral infection.

ACE2

ACE2, an enzyme created by the ACE2 protein, usually plays a role in the maintenance of blood pressure.

However, it has allied with the SARS-CoV 2 by functioning as a door to the cells.

In comparison to the SARS-CoV virus, the SARS-CoV-2 virus binds with a higher affinity to the ACE2 cell receptor, making it highly infectious.

An analysis of over 300,000 individuals variant data from across the world found variants in this gene that alters the receptor making it less friendly for the virus to bind to the host cell.

Individuals carrying such variants may thus be less susceptible to COVID-19.

HLA

A diverse set of human genes in the major histocompatibility complex encodes the human leukocyte antigens (HLAs).

Most people carry between three and six different HLA alleles that show geographic-specific distributions.

These proteins are important for how the immune system recognizes and mounts immune defenses against infection.

It is thus safe to say that HLA variations could affect your immune response to the virus.

A study found that HLA-B*46:01 variant had the fewest predicted binding sites, and therefore, reduced immune responses to SARS-CoV-2.

The gender bias

According to a study in China, the number of men who died from COVID-19 is 2.4 times that of women.

According to NYC Health, men account for almost 60% of COVID-19 deaths.

So, what puts men at a higher risk for COVID-19 infection when compared to women?

A study hypothesizes the involvement of TLR gene in this.

TLRs or Toll-Like Receptors are a class of proteins that play an important role in immune functioning.

Humans have ten classes of TLRs (TLR1 to TLR10).

TLR7 is a pattern recognition receptor present in several immune cells and can detect single-stranded RNA viruses, including coronaviruses.

The X chromosome encodes the TLR7 and TLR8 tandem.

Women carry 2 X chromosomes, whereas men carry an X and a Y chromosome.

Though one of the X chromosomes is inactivated in women, the  TLR7 and TLR8 tandem seems to have escaped this silencing resulting in higher expression levels of TLR7 in females in comparison to males.

ABO blood grouping 

A research study involving 1610 COVID-19 positive patients with respiratory failure established that blood type may play a key role in determining who contracts COVID-19 and how severe the illness becomes.

According to the study, blood group O is associated with a lower risk of acquiring COVID-19, whereas blood group A was associated with a higher risk.

The researchers are still a bit hazy on the exact science behind it, but some authors suggest that variations in biological mechanisms in ABO blood groups may play a role, specifically in their immune response. 

Response to drugs

Pharmacogenomics, the study of how genes affect your body’s response to drugs, is a rapidly growing field that is in the process of unlocking the key to preventing adverse drug effects.

The bolus of drug and genomics research occurring during the pandemic has lead to assessing the role of genetics in personalizing COVID-19 treatment. 

Hydroxychloroquine, used to treat malaria, rheumatoid arthritis, and lupus, had an approval initially by the FDA for clinical trials to treat COVID-19. 

However, the clinical trials recorded a significant number of arrhythmias, especially in patients with existing cardiovascular disease. 

Evaluating the genetic variants that contribute to the effectiveness of the drug metabolism can help alter the dosage accordingly to avoid such adverse side effects.

Xcode Life COVID-19 Genetic Report

Based on the key findings from the latest genetic research on COVID-19, we have curated a comprehensive report to enable you to understand your body better and align your care, diet, and therapy to your genetic type for the best support.

The report we have built consists of 4 sections:

1. Genetic risk for severe COVID-19

2. Genetic association with nutritional traits that may affect COVID-19 severity

3. Genetic influence on drug therapy

4. Genetics of the gut microbiome

How to use the report?

Please note that the COVID-19 genetic report is based on preliminary studies and is meant only for educational purposes.

This report should be interpreted only by a medical practitioner.

Any lifestyle modifications based on this report should be done only after consulting with a qualified medical practitioner. 

Your nutritional needs

The immune system is always active, carrying out surveillance, but there is an enhancement in its activity if an individual encounters an infection.

Several vitamins (A, C, D, and E) and trace elements (zinc, selenium) have been demonstrated to have key roles in supporting the human immune system and reducing the risk of infections.

It would seem prudent for individuals to consume sufficient amounts of essential nutrients to support their immune system.

While one can ensure nutritional sufficiency through diet, other factors may hinder your body from absorbing these nutrients well, making you prone to deficiencies.

For example, some genetic variants interfere with the proper metabolization and utilization of certain nutrients, ultimately leading to its deficiency.

Carriers of such variants may require additional supplementation.

The nutrition section of the report profiles the genetic variants associated with this process.

It also includes specific dietary recommendations to ensure that you are meeting your optimal nutritional needs.

Your drug response

Your genetic makeup has a big role in drug metabolization, and consequently the effect of the drugs on your body.

The same genetic variants also influence how well your body allows the drug to treat viral infections.

This section of the report focuses on analyzing these genetic variants.

The outcomes throw some light on which combination of drugs your body type may respond better to, ensuring little to no side effects. 

Your gut microbes

One of the serious clinical manifestations of COVID-19 is pneumonia and progression to acute respiratory distress syndrome (ARDS), especially in elderly, immune-compromised patients.

Numerous experimental and clinical observations have suggested that the gut microbiota plays a key role in the pathogenesis of sepsis and ARDS.

Loss of gut bacteria diversity can lead to dysbiosis, which may then be associated with many diseases.

Thus, the speculation of gut-lung connection influencing the clinical manifestation of COVID19 seems highly plausible.

In fact, according to research, nearly 60% of patients with COVID-19 show symptoms of gastrointestinal disturbance like diarrhea, vomiting, and nausea.

Some genetic variants aid a better growth of beneficial gut microbiome, thereby curbing all unwanted GI disturbances. 

You can order your COVID-19 Genetic Report here. 

25% to 50% of people who reported to hospitals in China with coronavirus in December 2019, had hypertension or other comorbidities like diabetes, cancer, or heart conditions. In Italy, 75% of COVID-related deaths included hypertensives. Hypertension and severe COVID symptoms have a genetic connection. But how interlinked are they? Read on to find out more!

Introduction

The clinical and epidemiological features of COVID-19 have been under constant study and several research studies have been published about it over the last several weeks.

A lot of focus is on the comorbidities that have an association with COVID, in particular.

The most common comorbidities in one report were hypertension (30%), diabetes (19%), and coronary heart disease (8%).

ACE inhibitors, which are used to treat hypertension, have been researched to increase the ACE2 receptor expression, to which the coronavirus binds to.

But, it is important to note that none of these can be declared as a 'cause' of COVID since these are more prevalent in the elders, who appear to be at an increased risk for COVID.

However, blood pressure control is extremely important to reduce the impact of COVID in your body.

Genetics and COVID

The coronavirus appears to affect any individual despite factors like their age or gender.

However, recent research reveals that some people tend to have more severe symptoms, in comparison to others who may experience mild symptoms or be completely asymptomatic.

Some genetic factors tend to influence how the virus enters your body, and consequently, how the virus affects you as well.

Hypertension - A risk factor for COVID?

There is a wide acceptance amongst the scientific community that there is a genetic risk factor that causes severe symptoms in some individuals, while rendering other asymptomatic.

One such disease that scientists have researched is hypertension.

The limited studies on this reveal that the novel coronavirus latches on to the human protein ACE2 receptors and gains entry into the lungs. 

Hypertensive individuals are prescribed Angiotensin-Converting Enzyme(ACE) inhibitors, and some studies have shown that these medications increase the number of ACE receptors, thereby increasing the portals for entry of the virus.

There are, however, opposing theories with a few groups of scientists saying that the ACE2 can actually protect the lungs from a very severe infection of 2019- nCov.

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Diabetes: A Common Comorbidity of COVID-19: Check Your Risk With 23andMe Raw Data

Genetics’ play in hypertension

A very common health condition that is prevalent today is hypertension or abnormally high blood pressure.

A blood pressure level of 120/80mm Hg is considered normal, and having blood pressure equal to or higher than 130/80 mm Hg is called hypertension, in an otherwise healthy individual. 

Though a common condition today, hypertension runs in families, and therefore, genetics and heredity may play a major role in determining the disease risk.

Individuals who have hypertensive parents tend to have an increased risk of developing the condition. However, how the exact inheritance of this condition is still unknown.

Many Genome-Wide studies have been conducted to study the influence of genes on the development of hypertension. 

Around 280 genetic variants have been found that are said to increase the risk of hypertension and other associated conditions such as coronary artery disease.

Hypertension and COVID: Reducing your risk using 23andMe DNA data

Some genes that have a significant role to play in the development of hypertension are –

With the currently available studies, it has been observed that there are many genes that play a role in the pathophysiology of hypertension. It is highly unlikely that just one or two will emerge as the leading genes associated with the condition.

Now it is as simple as just following 3 simple steps to identify your risk for hypertension using your DNA raw data.

Signs to look out for to check for COVID when you have hypertension

So far, it is quite evident that hypertension is high-risk comorbidity that results in severe symptoms if affected by COVID.

Pneumonia is one of the most common complications in severe cases.

In a hypertensive individual, high blood pressure damages the blood vessels and arteries. Therefore, it results in reduced blood flow to the heart.

As a result, your heart needs to work extra hard to pump blood, so it reaches all parts of your body.

When this happens over a period of time, it results in the weakening of the heart muscles.

The same effect can occur when there is hypercholesterinemia occurs together with hypertension.

Most common symptoms to look out for if you suspect a COVID infection include:

Tips for managing your blood pressure to reduce your risk for COVID

As a hypertensive individual, you need to take extra care to reduce your chances of contracting COVID. Here are some guidelines that you need to follow:

References

https://www.cebm.net/covid-19/coronaviruses-a-general-introduction/

https://academic.oup.com/eurheartj/article/38/29/2309/3852720

https://jasn.asnjournals.org/content/13/suppl_3/S155

https://academic.oup.com/ajh/article/33/5/373/5816609

https://pubmed.ncbi.nlm.nih.gov/24842388/

Do you have your DNA raw data file from 23andMe, AncestryDNA, FTDNA, LivingDNA, etc.?

Upload your DNA raw data to Xcode Life to know your genetic predisposition to hypertension.

Published on 29, June 2020

Diabetes is a chronic disorder wherein the body no longer responds to insulin. The disease could reduce the efficiency of the body’s immune system. As such, diabetes is a common comorbidity of COVID-19, with up to 20% of patients requiring intensive medical care. With lockdowns and social restrictions in place across the globe, here are some ways in which you can protect yourself from the novel coronavirus.

Introduction

The current COVID-19 pandemic has affected all our lives in one way or another. The cases report a range of symptoms from mild or asymptomatic cases to severe forms of pneumonia that could lead to the patient’s death.

With newer evidence released on a daily and monthly basis, researchers worldwide are trying to deduce the infection pattern, characteristic symptoms, potential treatment patterns, and drugs.

COVID-19 is an infection of a new coronavirus called the SARS-CoV-2 that emerged in the Wuhan region in China. This disease was so widely spread, that the World Health Organisation declared a global pandemic in March 2020.

The SARS-CoV-2 is a type of coronavirus, which falls under the same family as SARS and MERS. Some experiments have hypothesized that the virus has some affinity to angiotensin-converting enzyme receptor 2 (ACE2), which acts as the gateway to the human body.

Genetics and COVID-19

As many scientists rush to find the cure for the disease, a pressing question remains- why is there such a disparity between patients of COVID-19? How are there some individuals showing absolutely no symptoms, and on the other hand, why are some patients exhibiting severe pneumonia-like symptoms?

The known factors, like age and previous medical history, makes an individual more susceptible to showing severe symptoms.

However, there are cases of perfectly healthy young people showing severe symptoms as well. Some underlying genetic factors can be responsible for this.

As mentioned above, one hypothesized path that the virus takes to the body is through latching onto the ACE2 receptor.

Scientists have found variants of the gene that codes for ACE2, which could influence how the protein functions or impact the structure. This, in turn, affects how the virus could infect a person. 

Another factor that could influence how the virus infects an individual could be the person’s blood group.

The ABO gene determines the blood type of a person and could shine a light on how susceptible a person is to the virus. 

Both these genes are from preliminary studies, and this needs more validation and a larger group of volunteers to conclude any observation. 

Is diabetes a risk factor for COVID-19?

Diabetes is a condition in which there is an impairment in the body’s ability to produce or respond to insulin.

This results in abnormal levels of carbohydrates and elevated levels of glucose in the blood.

People with diabetes are at an increased risk, as they have an impaired immune response to infection.

This applies to both cytokine profiles and activation of T-cells and macrophages.

The impact of having an impaired response to insulin affects the body’s response to viral infection and potential secondary infection in the lungs. 

A study compared hospitalization rates of COVID-19 patients and the underlying medical conditions.

Of all the volunteers in the study, 7% were hospitalized and admitted in the ICU, and 77% were not hospitalized. While analyzing the patients with diabetes, up to 20% were hospitalized, and only 45% were not hospitalized.

This data shows that patients with diabetes require extra medical attention if diagnosed with COVID-19. 

Patients with type 2 diabetes are also at risk of being obese. This is an additional risk factor for severe infection.

In the case of the 2009 H1N1 epidemic, about twofold more patients diagnosed with the disease, with a history of obesity, ended in ICU, and took longer to recover. 

Finally, the most common co-morbidities to COVID-19 are hypertension and diabetes.

These diseases are both treated with ACE2 inhibitors.

This means that a patient with an ACE inhibitor would have an increased expression of ACE2.

Since the novel coronavirus targets ACE2, it could facilitate COVID-19 infection, and place these patients at a high risk of disease and fatality. 

Genetics and Diabetes

Genetics plays a role in type 2 diabetes; however, factors like lifestyle choices play a larger role in the manifestation of this disease.

A choice for healthy living can heavily lower the chances of developing type 2 diabetes.

This includes staying healthy by maintaining a healthy weight and choosing healthy foods.

It is possible to test for your genetic predisposition towards diabetes using your 23andMe DNA raw data.

Diabetes and COVID: Reducing your risk using 23andMe DNA data

If you have are a diabetic/ have a predisposition to diabetes, it is important to be prepared. Some measures that you can take are:

You May Also Want To Read

<br>Your Genes Do Not Sugarcoat When It Comes To Diabetes!

Diet plan for diabetes- COVID-19 version

There are three main pillars of diabetes maintenance, monitoring, exercise, and diet. Measures that you can take with respect to exercise and monitoring are explained above, and the following details a diet plan that you can follow. 

Summary

COVID-19 is caused by a novel coronavirus, SARS-CoV-2. The symptoms and the path of infection are still being studied, with new data being released on a daily basis. Individuals with comorbidities, especially like diabetes and hypertension, must strictly follow social distancing practices. If they do step out, measures of wearing a face mask, carrying a sanitizer, and washing hands thoroughly with soap can help prevent infection.

References

Could genetics play a role in the severity of COVID-19?

COVID-19 Information Center

COVID-19 Infection in People with Diabetes

https://www.idf.org/aboutdiabetes/what-is-diabetes/covid-19-and-diabetes/1-covid-19-and-diabetes.html

https://www.idf.org/aboutdiabetes/what-is-diabetes/covid-19-and-diabetes/1-covid-19-and-diabetes.html

Do you have your DNA raw data file from 23andMe, AncestryDNA, FTDNA, LivingDNA, etc.?

Upload your DNA raw data to Xcode Life to know your genetic predisposition to diabetes.

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