Whole-genome sequencing reveals host factors underlying critical COVID-19

Critical COVID-19 is caused by immune-mediated inflammatory lung injury. Host genetic variation influences the development of illness requiring critical care1 or hospitalization2,3,4 after infection with SARS-CoV-2. The GenOMICC (Genetics of Mortality in Critical Care) study enables the comparison of genomes from individuals who are critically ill with those of population controls to find underlying disease mechanisms. Here we use whole-genome sequencing in 7,491 critically ill individuals compared with 48,400 controls to discover and replicate 23 independent variants that significantly predispose to critical COVID-19. We identify 16 new independent associations, including variants within genes that are involved in interferon signalling (IL10RB and PLSCR1), leucocyte differentiation (BCL11A) and blood-type antigen secretor status (FUT2). Using transcriptome-wide association and colocalization to infer the effect of gene expression on disease severity, we find evidence that implicates multiple genes—including reduced expression of a membrane flippase (ATP11A), and increased expression of a mucin (MUC1)—in critical disease. Mendelian randomization provides evidence in support of causal roles for myeloid cell adhesion molecules (SELE, ICAM5 and CD209) and the coagulation factor F8, all of which are potentially druggable targets. Our results are broadly consistent with a multi-component model of COVID-19 pathophysiology, in which at least two distinct mechanisms can predispose to life-threatening disease: failure to control viral replication; or an enhanced tendency towards pulmonary inflammation and intravascular coagulation. We show that comparison between cases of critical illness and population controls is highly efficient for the detection of therapeutically relevant mechanisms of disease

“Astonishing successes” and “bitter disappointment”: The specific heat of hydrogen in quantum theory

The specific heat of hydrogen gas at low temperatures was first measured in 1912 by Arnold Eucken in Walther Nernst’s laboratory in Berlin, and provided one of the earliest experimental supports for the new quantum theory. Even earlier, Nernst had developed a quantum theory of rotating diatomic gas molecules that figured in the discussions at the first Solvay conference in late 1911. Between 1913 and 1925, Albert Einstein, Paul Ehrenfest, Max Planck, Fritz Reiche, and Erwin Schrödinger, among many others, attempted theoretical descriptions of the rotational specific heat of hydrogen, with only limited success. Quantum theory also was central to the study of molecular spectra, where initially it was more successful. Moreover, the two problems interacted in sometimes surprising ways. Not until 1927, following Werner Heisenberg’s discovery of the behavior of indistinguishable particles in modern quantum mechanics, did American theorist David Dennison find a successful theory of the specific heat of hydrogen