The COVID-19 pandemic continues to rage. New findings about the clinical presentation continue to unfold; but there are many questions to be answered as to why some SARS-CoV-2 infected individuals are extremely sensitive and develop severe acute respiratory distress syndrome (ARDS) while others are asymptomatic. It is known that advanced age and pre-existing conditions such as cardiovascular, pulmonary, and renal diseases render a person more vulnerable to the more severe health consequences of COVID-19 (Blanco-Melo et al., 2020). Thus, what makes some people more vulnerable than others to SARS-CoV-2 awaits scientific investigation. Studies on (Li et al., 2005) viruses may suggest genetics play a role in determining or influencing efficiency of infection, immune response to infection, and severity of COVID-19 in different individuals. A recent in silico analysis carried out by Nguyen and colleagues (2020) highlighted genetic variability in the human leucocyte antigen (HLA) system as potential determinants of a person’s resistance or susceptibility to the disease.  However, it is noteworthy that the analysis was based entirely on theoretical data, since individual-level HLA typing and data on clinical outcomes for populations affected by COVID-19 were not yet available, and therefore not able to assess the real impact of HLA type and other potential host genetic factors in COVID-19 outcomes.

This proposal seeks to characterize genomic variation of main HLA class I and class II genes as well as KIR genes and their associations (susceptibility/protection) with SARS-CoV-2 infection and specifically to; a) determine the molecular epidemiology of SARS-CoV-2 in infected individuals seen at three hospitals in Accra, Ghana, b) document COVID-19 presentations in SARS-CoV-2 infections in Ghana, c) determine the frequencies of ABO blood types and their association with COVID-19 clinical outcome in Ghanaian patients, d) characterize and determine the frequencies of class I and class II HLA and KIR genotypes among COVID-19 infected individuals, e) determine association between HLA/KIR genotypes and SARS-CoV-2 infection in Ghanaian patients and f) describe HLA/KIR alleles that influence outcome of COVID-19 in the study population.