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Being in the grips of a nightmare is a common occurrence that we can all relate to, but we may never experience one exactly as a particular artist depicts it. Here Fuseli conjures up a terrifying image filled with mystery and panic, yet with a vague and disturbing familiarity. It suggests the way the woman feels in the grip of a demonic nightmare, not what she sees. The Nightmare was reproduced as an engraving; a copy hung in Sigmund Freud's apartment in Vienna in the 1920s.
CVSHealth is committed to advancing health equity for the clients and communities we serve. Cross-sector communication and collaboration is key to advancing health equity, as it leverages and aligns strengths, skills, and resources to advance common health goals. The necessity and success of these innovative and collaborative efforts has been highlighted during the response to the COVID-19 pandemic, with new partnerships emerging around data infrastructure, health communications, testing, vaccination efforts, and distribution of critical supplies and equipment. Strong public-private partnerships aimed at addressing the social determinants of health (including quality food, housing, transportation, education, jobs) can accelerate health equity. To advance the body of evidence and share best and promising practices on public-private partnerships, CVSHealth is working with the Journal of Health Care for the Poor and Underserved to produce a supplemental issue dedicated to highlighting the impact and lessons learned from public-private partnerships focused on advancing health equity. In support of this objective researchers from academia, industry, government, and community-based organizations are invited to submit abstracts of 350 words or less concerning original research on the public-private partnership health equity theme. The organizing committee will review the abstracts and issue invitations to submit full papers to those chosen. The details for submission are outlined below.
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For some of these analyses, the controls were simply existing population controls without knowledge of SARS-CoV-2 infection or COVID-19 status, which may bias effect size estimates as some of these individuals may have either become infected with SARS-CoV-2 or developed COVID-19. We perform several sensitivity analyses (Extended Data Fig. 7b, Supplementary Note and Supplementary Table 4) in which we show that using population controls can be a valid and powerful strategy for host genetic discovery of infectious disease, and particularly those that are widespread and with rare severe outcomes.
Lastly, there are two loci in the 3p21.31 region with varying genes prioritized by different methods for different independent signals. For the severity lead variant rs10490770:T>C, we prioritized CXCR6 with the Variant2Gene (V2G) algorithm26, although LZTFL1 is the closest gene. The CXCR6 has a role in chemokine signalling27 and LZTFL1 has been implicated in lung cancer28. rs2271616:G>T, which is associated with susceptibility, tags a complex region including several independent signals (Supplementary Note) that are all located within the gene body of SLC6A20, which encodes a protein that is known to functionally interact with the SARS-CoV-2 receptor ACE229. However, none of the lead variants in the 3p21.31 region has been previously associated with other traits or diseases in our PheWAS analysis. Although these results provide supporting in silico evidence for candidate causal gene prioritization, further functional characterization is needed. Detailed locus descriptions and LocusZoom plots are provided in Supplementary Fig. 2.
The COVID-19 HGI has brought together investigators from across the world to advance genetic discovery for SARS-CoV-2 infection and severe COVID-19 disease. We report 13 genome-wide significant loci associated with some aspect of SARS-CoV-2 infection or COVID-19. Many of these loci overlap with previously reported associations with lung-related phenotypes or autoimmune or inflammatory diseases, but some loci have no obvious candidate gene.
Four out of the thirteen genome-wide significant loci showed similar effects in the reported SARS-CoV-2 infection analysis (a proxy for disease susceptibility) and all-hospitalized COVID-19 (a proxy for disease severity). Of these, one locus was in close proximity to, yet independent of, the major genetic signal for COVID-19 severity at the 3p21.31 locus. Notably, this locus was associated with COVID-19 susceptibility rather than severity. The locus overlaps SLC6A20, which encodes an amino acid transporter that interacts with ACE2. Nonetheless, we caution that more data are needed to resolve the nature of the relationship between genetic variation and COVID-19 at this locus, particularly as the physical proximity, LD structure and patterns of association suggest that untagged genetic variation could drive the association signal in the region. Our findings support the notion that some genetic variants, most notably at the ABO and PPP1R15A loci, in addition to SLC6A20, can indeed affect susceptibility to infection rather than progression to severe COVID-19 once infected.
Care should be taken when interpreting the results from a meta-analysis because of challenges with case and control ascertainment and collider bias (see Supplementary Note for a more detailed discussion on study limitations). Drawing a comprehensive and reproducible map of the host genetics factors associated with COVID-19 severity and SARS-CoV-2 requires a sustained international effort to include diverse ancestries and study designs. To accelerate downstream research and therapeutic discovery, the COVID-19 HGI regularly publishes meta-analysis results from periodic data freezes on the website and provides an interactive explorer through which researchers can browse the results and the genomic loci in more detail. Future work will be required to better understand the biological and clinical value of these findings. Continued efforts to collect more samples and detailed phenotypic data should be endorsed globally, allowing for more thorough investigation of variable, heritable symptoms, particularly in light of the newly emerging strains of SARS-CoV-2, which may provoke different host responses that lead to disease.
To prioritize candidate causal genes reported in full in Supplementary Table 2, we used various gene prioritization approaches using both locus-based and similarity-based methods. Because we only describe the in silico gene prioritization results without characterizing the actual functional activity in vitro or in vivo, we aimed to provide a systematic approach to nominate potential causal genes in a locus using the following criteria.
To recruit new international partner studies, we developed a workflow in which new studies are registered and verified by a curation team ( ). Users can explore the registered studies using a customized interface to find and contact studies with similar goals or approaches ( ). This helps to promote organic assembly around focused projects that are adjacent to the centralized effort ( ). Visitors can query study information, including study design and research questions. Registered studies are visualized on a world map and are searchable by institutional affiliation, city and country.
To encourage data sharing and other forms of participation, we created a rolling acknowledgements page ( ) and directions on how to contribute data to the central meta-analysis effort ( -sharing). Upon the completion of each data freeze, we post summary statistics, plots and sample size breakdowns for each phenotype and contributing cohort ( ). The results can be explored using an interactive web browser ( ). Several computational research groups carry out follow-up analyses, which are made available for download ( -silico). To enhance scientific communication to the public, preliminary results are described in blog posts by the scientific communications team and shared on Twitter. The first post was translated to 30 languages with the help of 85 volunteer translators. We compile publications and preprints submitted by participating groups and summarize genome-wide significant findings from these publications ( ).
The Missing Person Information Clearinghouse was established July 1, 1985, within the Department of Public Safety providing a program for compiling, coordinating and disseminating information in relation to missing persons and unidentified body/persons. Housed within the Division of Criminal Investigation, the Clearinghouse assists in helping to locate missing persons through public awareness and cooperation, and in educating law enforcement officers and the general public about missing person issues. 2b1af7f3a8

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