While some become infected with Covid-19 on first contact and suffer from severe symptoms for weeks, others simply do not get infected. There are many possible explanations for this. A new study has now identified a risk gene for severe courses.

Different factors influence the likelihood of contracting Covid-19. They also decide how severe the course of the disease will be in the event of infection. In addition to age, weight, health condition or possible previous illnesses, the blood group also affects how easily we can become infected.

But what exactly is behind it? And why do even young people sometimes get seriously ill with Sars-CoV-2? A new study by the Berlin Institute of Health has identified a risk gene that could have a direct impact on the severity of the disease.

The researchers found that the ELF5 gene, which is active in the pulmonary alveoli and the olfactory epithelium, significantly increases the risk of a severe or fatal course in the event of an infection with the coronavirus. These areas are considered the first target of the coronavirus.

Lung alveoli are the smallest structural elements of the lungs, in which the gas exchange between blood and alveolar air takes place during respiration. The olfactory epithelium, in turn, is a specialized tissue for the sensory perception of smells, which is located within the nasal mucosa.

Several genetic risk factors were previously found – including variants in the ABO blood group – that explain why people with blood group A get sick more often than people with blood group 0. Due to the variants in the blood group gene, the latter are not protected from a severe course in the event of an illness – unlike the newly researched ELF5 gene.

As part of the current investigations, the researchers found eight different proteins that influence the risk of disease. Of these, ELF5 had the greatest impact on the course and outcome of a Covid-19 infection.

ELF5 contains the information for a so-called transcription factor – a protein that influences the reading (transcription) of other genes.

The investigations revealed that the gene in people in whom it is particularly strongly activated increases the risk of a severe course with hospitalization or death fivefold.

It is assumed that ELF5 makes it easier for the virus to enter and spread into the cells of the respiratory tract – put simply – and possibly also have a negative effect on the immune responses there. ELF5 is formed in different regions of the airways and nose:

According to the authors of the study, it is therefore plausible that ELF5 has a beneficial effect on the infection and the development of the course of the disease. However, the exact role played by the gene has not yet been finally clarified and is difficult to study in the case of transcription factors, since they usually influence the activity of several other genes. Accordingly, the findings are not relevant for the development of new active ingredients.

In addition to genetic risk factors, a study by the National Institutes of Health in the USA identified further risk factors for a severe course at the beginning of the year. This includes:

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In order to be able to reduce your own risk of developing a serious course of the disease, you can take measures yourself. These include: