The Role of Immunogenetics in COVID-19

Int J Mol Sci. 2021 Mar 5;22(5):2636. doi: 10.3390/ijms22052636.


Coronavirus disease 2019 (COVID-19) is induced by SARS-CoV-2 and may arise as a variety of clinical manifestations, ranging from an asymptomatic condition to a life-threatening disease associated with cytokine storm, multiorgan and respiratory failure. The molecular mechanism behind such variability is still under investigation. Several pieces of experimental evidence suggest that genetic variants influencing the onset, maintenance and resolution of the immune response may be fundamental in predicting the evolution of the disease. The identification of genetic variants behind immune system reactivity and function in COVID-19 may help in the elaboration of personalized therapeutic strategies. In the frenetic look for universally shared treatment plans, those genetic variants that are common to other diseases/models may also help in addressing future research in terms of drug repurposing. In this paper, we discuss the most recent updates about the role of immunogenetics in determining the susceptibility to and the history of SARS-CoV-2 infection. We propose a narrative review of available data, speculating about lessons that we have learnt from other viral infections and immunosenescence, and discussing what kind of aspects of research should be deepened in order to improve our knowledge of how host genetic variability impacts the outcome for COVID-19 patients.

Keywords: AB0; COVID-19; HLA; KIR; SARS-CoV-2; immunogenetics.

Publication types

  • Review

MeSH terms

  • ABO Blood-Group System / immunology
  • COVID-19 / blood
  • COVID-19 / epidemiology
  • COVID-19 / genetics
  • COVID-19 / immunology*
  • Disease Susceptibility / immunology
  • Genetic Predisposition to Disease
  • HLA Antigens / blood
  • HLA Antigens / genetics
  • HLA Antigens / immunology
  • Humans
  • Immunity / genetics
  • Immunogenetics*
  • Severity of Illness Index


  • ABO Blood-Group System
  • HLA Antigens