Genetic variants of PIEZO1 associate with COVID-19 fatality

Fatality from coronavirus disease 19 (COVID-19) is a major problem globally and so identification of its underlying molecular mechanisms would be helpful. The combination of COVID-19 clinical data and genome sequence information is providing a potential route to such mechanisms. Here we took a candidate gene approach to UK Biobank data based on the suggested roles of endothelium and membrane proteins in COVID-19. We focussed on the PIEZO1 gene, which encodes a non-selective cation channel that mediates endothelial responses to blood flow. The analysis suggests 3 missense PIEZO1 single nucleotide polymorphisms (SNPs) associated with COVID-19 fatality independently of risk factors. All of them affect amino acids in the proximal N-terminus of PIEZO1, which is an unexplored region of the protein. By using molecular modelling we predict location of all 3 amino acids to a common outward-facing structure of unknown functional significance at the tips of the PIEZO1 propeller blades. Through genome sequence analysis we show that these SNPs vary in prevalence with ethnicity and that the most significant SNP (rs7184427) varies between 65 to 90% even though the reference amino acid is evolutionarily conserved. The data suggest PIEZO1 as a contributor to COVID-19 fatality and factor in ethnic susceptibility.