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Silva BRS, Jara CP, Sidarta-Oliveira D, Velloso LA, Velander WH, Araújo EP. Downregulation of the Protein C Signaling System Is Associated with COVID-19 Hypercoagulability-A Single-Cell Transcriptomics Analysis. Viruses 2022; 14:2753. [PMID: 36560757 PMCID: PMC9785999 DOI: 10.3390/v14122753] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2022] [Revised: 11/14/2022] [Accepted: 12/05/2022] [Indexed: 12/14/2022] Open
Abstract
Because of the interface between coagulation and the immune response, it is expected that COVID-19-associated coagulopathy occurs via activated protein C signaling. The objective was to explore putative changes in the expression of the protein C signaling network in the liver, peripheral blood mononuclear cells, and nasal epithelium of patients with COVID-19. Single-cell RNA-sequencing data from patients with COVID-19 and healthy subjects were obtained from the COVID-19 Cell Atlas database. A functional protein-protein interaction network was constructed for the protein C gene. Patients with COVID-19 showed downregulation of protein C and components of the downstream protein C signaling cascade. The percentage of hepatocytes expressing protein C was lower. Part of the liver cell clusters expressing protein C presented increased expression of ACE2. In PBMC, there was increased ACE2, inflammatory, and pro-coagulation transcripts. In the nasal epithelium, PROC, ACE2, and PROS1 were expressed by the ciliated cell cluster, revealing co-expression of ACE-2 with transcripts encoding proteins belonging to the coagulation and immune system interface. Finally, there was upregulation of coagulation factor 3 transcript in the liver and PBMC. Protein C could play a mechanistic role in the hypercoagulability syndrome affecting patients with severe COVID-19.
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Affiliation(s)
- Bruna Rafaela Santos Silva
- Nursing School, University of Campinas, Tessalia Vieira de Camargo, 126, Campinas 13084-970, Brazil
- Laboratory of Cell Signalling, Obesity and Comorbidities Center, OCRC, University of Campinas, Carl Von Linnaeus, s/n, Campinas 13084-864, Brazil
| | - Carlos Poblete Jara
- Department of Chemical and Biomolecular Engineering, University of Nebraska, Lincoln, NE 68588-0643, USA
| | - Davi Sidarta-Oliveira
- Laboratory of Cell Signalling, Obesity and Comorbidities Center, OCRC, University of Campinas, Carl Von Linnaeus, s/n, Campinas 13084-864, Brazil
- School of Medical Sciences, University of Campinas, Tessalia Vieira de Camargo, 126, Campinas 13083-887, Brazil
| | - Licio A. Velloso
- Laboratory of Cell Signalling, Obesity and Comorbidities Center, OCRC, University of Campinas, Carl Von Linnaeus, s/n, Campinas 13084-864, Brazil
- School of Medical Sciences, University of Campinas, Tessalia Vieira de Camargo, 126, Campinas 13083-887, Brazil
| | - William H. Velander
- Department of Chemical and Biomolecular Engineering, University of Nebraska, Lincoln, NE 68588-0643, USA
| | - Eliana P. Araújo
- Nursing School, University of Campinas, Tessalia Vieira de Camargo, 126, Campinas 13084-970, Brazil
- Laboratory of Cell Signalling, Obesity and Comorbidities Center, OCRC, University of Campinas, Carl Von Linnaeus, s/n, Campinas 13084-864, Brazil
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Yuan X, Tong X, Wang Y, Wang H, Wang L, Xu X. Coagulopathy in elderly patients with coronavirus disease 2019. Aging Med (Milton) 2020; 3:260-265. [PMID: 33392432 PMCID: PMC7771561 DOI: 10.1002/agm2.12133] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2020] [Revised: 10/15/2020] [Accepted: 10/15/2020] [Indexed: 01/16/2023] Open
Abstract
BACKGROUND Since the outbreak of coronavirus disease 2019 (COVID-19), clinical features have been analyzed in detail. However, coagulopathy in elderly COVID-19 patients has been scarcely reported. METHODS Coagulation parameters of 189 patients with COVID-19 in Tongji hospital were retrospectively analyzed among age groups. RESULTS Patients were divided into 2 groups: older group (≥65 years, n = 87) and younger group (<65 years, n = 102). The proportion of patients with elevated fibrinogen (79.0% vs 59.6%, p = .005) and D-dimer (78.0% vs 55.2%, p = .001) shows the significant difference between the groups. The elderly patients revealed significantly longer prothrombin time (14.0 [13.4-14.4]s vs 13.6 [13.2-14.1]s, p = .026), higher D-dimer (1.00 [0.5-1.9] μg/mL vs 0.6 [0.3-1.6] μg/mL, p = .013) and fibrinogen (5.2 [4.1-6.2] g/L vs 4.4 [3.4-5.7] g/L, p = .004) levels, compared to the younger group. A positive correlation was observed between the coagulation parameters and inflammatory markers including high-sensitivity C-reactive protein and interleukin-6 (p < .05). CONCLUSIONS The hypercoagulable state is more common in elderly COVID-19 patients, and coagulopathy is associated with excessive systemic inflammation.
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Affiliation(s)
- Xueting Yuan
- The Key Laboratory of Geriatrics, Beijing Institute of Geriatrics, Beijing Hospital, National Center of Gerontology, National Health Commission; Institute of Geriatric Medicine, Chinese Academy of Medical SciencesP. R. China
| | - Xunliang Tong
- Department of Pulmonary and Critical Care MedicineBeijing Hospital, National Center of Gerontology; Institute of Geriatric Medicine, Chinese Academy of Medical SciencesP. R. China
| | - Yan Wang
- Department of Pulmonary and Critical Care MedicineBeijing Hospital, National Center of Gerontology; Institute of Geriatric Medicine, Chinese Academy of Medical SciencesP. R. China
| | - He Wang
- Department of Pulmonary and Critical Care MedicineBeijing Hospital, National Center of Gerontology; Institute of Geriatric Medicine, Chinese Academy of Medical SciencesP. R. China
| | - Liuming Wang
- Tongji Hospital, Tongji Medical College, Huazhong University of Science and TechnologyHubeiChina
| | - Xiaomao Xu
- The Key Laboratory of Geriatrics, Beijing Institute of Geriatrics, Beijing Hospital, National Center of Gerontology, National Health Commission; Institute of Geriatric Medicine, Chinese Academy of Medical SciencesP. R. China
- Department of Pulmonary and Critical Care MedicineBeijing Hospital, National Center of Gerontology; Institute of Geriatric Medicine, Chinese Academy of Medical SciencesP. R. China
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