Clonal chromosomal mosaicism and loss of chromosome Y in men are risk factors for SARS-CoV-2 vulnerability in the elderly

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Abstract

The ongoing pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2, COVID-19) has an estimated overall case fatality ratio of 1.38% (pre-vaccination), being 53% higher in males and increasing exponentially with age. Among 9578 individuals diagnosed with COVID-19 in the SCOURGE study, we found 133 cases (1.42%) with detectable clonal mosaicism for chromosome events (CME) and 226 males (5.08%) with acquired loss of chromosome Y (LOY). Individuals with clonal mosaic events (CME and/or LOY) showed a 54% increase in the risk of COVID-19 lethality. LOY is associated with transcriptomic biomarkers of immune dysfunction, pro-coagulation activity and cardiovascular risk. Interferon-induced genes involved in the initial immune response to SARS-CoV-2 are also down-regulated in LOY. Thus, CME and LOY underlie at least part of the sex-biased severity and mortality of COVID-19 in aging patients. Given its potential therapeutic and prognostic relevance, evaluation of clonal mosaicism should be implemented as biomarker of COVID-19 severity in elderly people.

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  1. SciScore for 10.1101/2020.04.19.20071357: (What is this?)

    Please note, not all rigor criteria are appropriate for all manuscripts.

    Table 1: Rigor

    NIH rigor criteria are not applicable to paper type.

    Table 2: Resources

    Experimental Models: Cell Lines
    SentencesResources
    One corresponds to primary human lung epithelium (NHBE) and the other to transformed lung alveolar cells (A549).
    A549
    suggested: NCI-DTP Cat# A549, RRID:CVCL_0023)
    Software and Algorithms
    SentencesResources
    The expression dataset is publicly available at GEO (Gene Expression Omnibus) under the accession number GSE48348.18 In this dataset, a total of 11 individuals with LOY were identified.
    Gene Expression Omnibus
    suggested: (Gene Expression Omnibus (GEO, RRID:SCR_005012)
    Array quality was assessed using arrayQualityMetrics Bioconductor package.
    arrayQualityMetrics
    suggested: (arrayQualityMetrics, RRID:SCR_001335)
    Bioconductor
    suggested: (Bioconductor, RRID:SCR_006442)
    Differential expression (DE) between individuals with and without LOY was then performed using limma Bioconductor package.
    limma
    suggested: (LIMMA, RRID:SCR_010943)
    Significant DE genes at p<0.001 level were selected for Gene Ontology (GO) and KEGG (Kyoto Encyclopedia of Genes and Genomes) enrichment analysis with clusterProfiler Bioconductor package.
    KEGG
    suggested: (KEGG, RRID:SCR_012773)
    clusterProfiler
    suggested: (clusterProfiler, RRID:SCR_016884)
    All statistical analyses were performed using the statistical software R version 3.6.3 (http://www.r-project.org).
    http://www.r-project.org
    suggested: (R Project for Statistical Computing, RRID:SCR_001905)

    Results from OddPub: Thank you for sharing your data.


    Results from LimitationRecognizer: An explicit section about the limitations of the techniques employed in this study was not found. We encourage authors to address study limitations.

    Results from TrialIdentifier: We found the following clinical trial numbers in your paper:

    IdentifierStatusTitle
    NCT04326920CompletedSargramostim in Patients With Acute Hypoxic Respiratory Fail…


    Results from Barzooka: We did not find any issues relating to the usage of bar graphs.


    Results from JetFighter: We did not find any issues relating to colormaps.


    Results from rtransparent:
    • Thank you for including a conflict of interest statement. Authors are encouraged to include this statement when submitting to a journal.
    • Thank you for including a funding statement. Authors are encouraged to include this statement when submitting to a journal.
    • No protocol registration statement was detected.

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