A defining feature of the COVID-19 pandemic has been the wide spectrum of clinical presentations, ranging from asymptomatic viremia to life-threatening illness.

Factors such as advancing age and co-morbid status have been shown to strongly correlate with risk of developing severe COVID-19, but that is unlikely to be the whole story.

Although the death rate in older patients is significantly higher than in their younger counterparts, a large proportion of elderly patients recover without having developed severe disease.

Beyond age and co-morbid status, what additional factors might protect an individual from severe disease once exposed? One suggestion that emerged early in the pandemic was that the patient’s own genetics might play a role in the way their body responds to infection.

There has been a staggering international effort to investigate this and last week, Nature published findings from the Genomics of Mortality in Critical Care (GenOMICC) study.

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