Approved Research

Lifestyle, ethnicity, and genetic factors for COVID-19 infection and severity

Lay summary

The COVID-19 pandemic has a huge global impact, yet its long-term effects are to be revealed. The disease is caused by infection of a virus called SARS-CoV-2, to which people may respond differently. The severity of infection ranges from asymptomatic, mild, moderate, severe to death. Current research has shown that advanced age, male gender, smoking, and physical inactivity are related to COVID-19 infection and adverse outcomes. Underlining health conditions, such as obesity, diabetes, hypertension, and heart and lung diseases, are associated with unfavorable outcomes. In the UK, South Asians and Afro-Caribbeans have shown a disproportionately higher risk of adverse outcomes than white Europeans. A strong immune system is important in our host defense to fight against foreign invaders. It is affected by the aforementioned factors, diet, nutrition, genetic composition, and other factors.

To date, research data on lifestyle and genetic factors related to COVID-19 infection and severity are scarce. Using UK Biobank data, we aim to study how lifestyle factors, including diet and nutrition, environment, ethnicity, health status, and genetic factors affect people's response to the infection, in other words, the tendency to be infected and the severity of the disease. We will explore the factors that explain the excess risk in UK minorities, in particular, South Asians, in combining with additional data. Prevention is better than cure. The knowledge we gained may guide us in the prevention and mitigation of current and future epidemics or pandemics from this or other deadly viruses. For instance, apart from wearing face masks, washing hands, social distancing, and vaccination, proactively adopting a simple healthy lifestyle may enhance our host defense (immunity) and lower the risk of infection and severe outcomes.

Scope extension:

The current coronavirus disease 2019 (COVID-19) pandemic has caused global disruption. Those who are in contact with or infected by the virus respond differently in terms of infection and outcome (severity). UK minorities including South Asians showed a disproportionately higher risk of infection and death than white Europeans. We propose to study lifestyle, environment, ethnicity, health status, and host genetic factors and identify new risk factors for COVID-19 infection and severity. By combining data with the London Life Sciences Prospective Population (LOLIPOP) study, we will identify risk factors contributing to the excess adverse outcome in South Asians. The findings from this study may facilitate the prevention and mitigation of current and future pandemics. Hence the proposal has the following aims:

1. To describe the morbidity and mortality of COVID-19 infection in South Asians and European whites.
2. To identify lifestyle and environmental risk factors for COVID-19 infection and severity;
3. To identify common genetic variants associated with COVID-19 infection and severity;
4. To explore the interplay between genetic and lifestyle factors in COVID-19 infection and severity;
5. To identify lifestyle and genetic factors contributing to the excess risk of COVID-19 in South Asians and other minority groups.

COVID-19 outcomes are highly associated with multi-comorbidity. COVID-19 may also affect the outcomes of these diseases, especially cardiovascular disease. It is known that the incidence and progression of these diseases can differ across different ethnic groups. Therefore, apart from the above, we will study how COVID-19 infection affects the prognosis of other diseases, and vice versa. We will combine the results with the LOLIPOP data to elucidate ethnic differences between South Asian and White European ethnic groups.