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Can Genetics Explain the Misleading Sequence of SARS-CoV-2 Symptoms?

 


An image of a man in protective clothing standing next to a car.
Expanding / Drive-through coronavirus test station.

Dry cough. Loss of odor. diarrhea. heat. All of these are considered to be possible symptoms associated with SARS-CoV-2 infection and may have no symptoms at all. Lack of adequate testing capacity has forced many parts of the United States to assign limited testing to only those who are suspected of having COVID-19 symptoms. However, given the difficulty in determining which symptoms actually indicate a possible infection, making them is a difficult decision to make.

An embarrassing set of symptoms raises the question of why people react so differently to the same virus.

Understanding what’s happening during a pandemic is an incredible challenge. Let’s look at some preliminary reports on one way to do that. This is not because the results are likely to persist as more research is done, but researchers are infected with the virus.

Symptoms or accidents?

Currently on the CDC website List various symptoms Associated with COVID-19. Some of these have high expectations for viral infections of the lungs: fever and chills, cough, shortness of breath, sore throat. However, some are less obvious, such as headaches, muscle aches, and loss of smell.

Such lists are typically aggregated medical reports to help physicians understand and update symptoms during hospitalization and treatment of patients. However, the lack of testing poses a serious problem to this effort. First, we Struggling to understand The number of people infected without medical care. The advent of the pandemic coincided with the flu season and the onset of seasonal allergies.

Finally, the list of symptoms is generally a product of the patient’s own memory, as he is asked to describe the occurrence of the problem. Memory can be problematic because the medical need itself can enhance recall of symptoms that may otherwise be ignored. A broader awareness of the list of symptoms like CDC serves the same purpose.

To complicate matters, some problems appear to affect a relatively small subset of infected people. Various reports report SARS-CoV-2 Clot formationProbably through its infection Lining of blood vessels. The same applies Gastrointestinal symptoms. The receptors used by the virus to enter cells are also found in the kidneys, and many hospitalized patients Need dialysis. While some patients appear to be vulnerable to severe symptoms, it remains unclear why other patients have subclinical infections.

Eventually, a lot of lab work will be needed to understand what’s happening. For example, you need to find out if the virus can grow in kidney cells and to determine the nature of kidney damage. However, another group of researchers is looking for ways to understand the onset of COVID-19 symptoms in real time.

what happens?

Two recent draft papers describe the early results of a collaboration between Harvard Health Researchers and King’s College in London. They worked with an application development company to create a simple application for mobile devices. COVID symptom tracker Ask the user a series of questions every day. These focus on the known symptoms of COVID-19 (which may be updated as the list grows), and the test results and treatments received.

This approach has some drawbacks. The user has a smartphone of his own choosing. This probably means a young population. And the app will only ask about the symptoms that the developer has enabled. However, this approach trades these limitations and some important advantages. The first is to simply scale. Between the US and UK, the app has reached 2.2 million users by the end of March. Second, don’t worry about recall bias. People enter symptoms whenever they occur. Previous They know they are associated with a positive diagnosis. Later, even initial symptoms and treatment may be correlated with patient outcome.

how are you? Draft Application description Here is some initial analysis of the user. It turned out that it is normal for people to take a test after reporting a cough or fatigue, but these were not really strongly associated with the test returning positive. The same was true if someone had diarrhea but no other symptoms. Instead, a positive diagnosis was made if cough and fatigue were associated with diarrhea and loss of odor. In fact, results suggest that odor loss was more common than fever among people who eventually tested positive for the virus.

Last week the team Follow-up draft We will start investigating the functions related to these symptoms. Look at that Twin population He offered to participate in a health survey in the UK. Many of them (over a little over 2,500) use this application, and researchers used it to try to figure out if genetics could affect the symptoms people experience. .

Limitations

The problem here is that none of them have been diagnosed to do any analysis. Therefore, the researchers had nothing to do with the actual SARS-CoV-2 infection. Instead, it correlated with the predictive value of positive diagnosis, as determined in a previous draft manuscript. That is clearly one of the greatest weaknesses of this work. Second, it covered a very short period from March 25th to April 3rd.

With these notes in mind, you should get the results over the entire salt flat. However, there are some interesting potential consequences that may be worth tracking for long-term follow-up. They suggest that there is an important genetic component in those who may lead to COVID-19 diagnosis, and 50% are likely to be genetic (error range was 30-80% But). In addition, a number of symptoms, such as fever, fatigue, loss of odor, and diarrhea, also appear to be genetically linked. There was no cough, chest pain, or abdominal pain.

While this survey does not change our current understanding, it does provide an interesting model of how a quality survey works. This is a potential reason to publish the draft first. And there’s no reason we couldn’t finally test all the participants to get a clearer picture of what was happening, so this survey will ultimately be what we are looking for. Clearly there is a possibility. In the long run, instead of relying on twins, you may also want to do genome-wide research on unrelated individuals.

This research should not be seen as more than a hint of what is possible, but something is affecting the body’s response to this virus in distinctly different individuals. Genetics is one rational candidate for influencing it.

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