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The genetic make-up of an individual contributes to the susceptibility and response to viral infection. Although environmental, clinical and social factors have a role in the chance of exposure to SARS-CoV-2 and the severity of COVID-191,2, host genetics may also be important. Identifying host-specific genetic factors may reveal biological mechanisms of therapeutic relevance and clarify causal relationships of modifiable environmental risk factors for SARS-CoV-2 infection and outcomes. We formed a global network of researchers to investigate the role of human genetics in SARS-CoV-2 infection and COVID-19 severity. Here we describe the results of three genome-wide association meta-analyses that consist of up to 49,562 patients with COVID-19 from 46 studies across 19 countries. We report 13 genome-wide significant loci that are associated with SARS-CoV-2 infection or severe manifestations of COVID-19. Several of these loci correspond to previously documented associations to lung or autoimmune and inflammatory diseases3,4,5,6,7. They also represent potentially actionable mechanisms in response to infection. Mendelian randomization analyses support a causal role for smoking and body-mass index for severe COVID-19 although not for type II diabetes. The identification of novel host genetic factors associated with COVID-19 was made possible by the community of human genetics researchers coming together to prioritize the sharing of data, results, resources and analytical frameworks. This working model of international collaboration underscores what is possible for future genetic discoveries in emerging pandemics, or indeed for any complex human disease.
A paradigm for thinking about wholes, their constitution and re-production, has long been provided by living organisms. While the emphasis is often on the relation between parts and wholes - between the functionally differentiated organs and the organism, or, on a lower level, between cells and organs - Robert Meunier and Valentine Reynaud's essay 'The Innate Plasticity of Bodies and Minds: Integrating Models of Genetic Determination and Environmental Formation' poses the question of the whole in biology with respect to the organism and its environment. A developmental system involves not only what we conventionally discern as the organism, that is, initially, the fertilized egg and the cellular mass arising from it by cell division, but also the physical and biological surrounding of the developing embryo. In the sense that not every aspect of the environment plays a role, the organism as part of the system constitutes this whole by determining what has an effect on the process and what does not. On the other hand, by not only enabling development or providing material but instead shaping the process in specific ways, the whole of organism-environment interactions constitutes its part, i.e., the developing organism. If there are therefore different, potentially incommensurable constitutions of the whole developmental system, there are also different ways of identifying the relevant units of selection in evolution, such as the living organism as a whole or the genes as the units of replication. In their essay, Meunier and Reynaud argue for a view on development and evolution that integrates notions of environmental influence and genetic determination. The notion of plasticity that has recently gained currency in the life sciences seems to oppose genetic determination and innateness by underlining the importance of environmental influence. However, while morphological and cognitive development is indeed plastic and sensitive to the environment, the essay emphasizes that the mechanisms and elements enabling a system to respond to influences must be available for development to happen in the first place. These resources for development are not homogeneous 'stuff' that becomes formed by the environment through the course of development. Instead, they are highly structured and specific and thus enable specific responses to contextual conditions. Under varying conditions they will of course appear in different combinations and produce different outcomes. Thus, they enable plasticity. And yet, as they are specific mechanisms and elements, which mainly gain their specificity from the structure of the genetic material on which the environment can act, it appears appropriate to refer to them as innate.