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Fevraleva I, Mamchich D, Vinogradov D, Chabaeva Y, Kulikov S, Makarik T, Margaryan V, Manasyan G, Novikova V, Rachina S, Melkonyan G, Lytkina K. Role of Genetic Thrombophilia Markers in Thrombosis Events in Elderly Patients with COVID-19. Genes (Basel) 2023; 14:genes14030644. [PMID: 36980916 PMCID: PMC10048352 DOI: 10.3390/genes14030644] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2023] [Revised: 02/20/2023] [Accepted: 03/02/2023] [Indexed: 03/08/2023] Open
Abstract
Thrombosis is an extremely dangerous complication in elderly patients with COVID-19. Since the first months of the pandemic, anticoagulants have been mandatory in treatment protocols for patients with COVID-19, unless there are serious contraindications. We set out to discover if genetic thrombophilia factors continue to play a triggering role in the occurrence of thrombosis in patients with COVID-19 with prophylactic or therapeutic anticoagulants. We considered the following genetic markers as risk factors for thrombophilia: G1691A in the FV gene, C677T and A1298C in the MTHFR gene, G20210A and C494T in the FII gene, and (−675) 4G/5G in the PAI-I gene. In a cohort of 176 patients, we did not obtain a reliable result indicating a higher risk of thrombotic complications when taking therapeutic doses of anticoagulants in carriers of genetic markers for thrombophilia except the C494T mutation in the FII gene. However, there was still a pronounced tendency to a higher incidence of thrombosis in patients with markers of hereditary thrombophilia, such as FV G1691A and FII G20210A mutations. The presence of the C494T (Thr165Met) allele in the FII gene in this group of patients showed a statistically significant effect of the mutation on the risk of thrombotic complications despite anticoagulant therapy.
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Affiliation(s)
- Irina Fevraleva
- National Medical Research Center for Hematology, Novy Zykovski Lane 4a, 125167 Moscow, Russia
- Correspondence:
| | - Daria Mamchich
- Hospital Therapy Department No. 2, I.M. Sechenov First Moscow State Medical University, RF Health Ministry, Bolshaya Pirogovskaya St. 2, Bld. 4, 119435 Moscow, Russia
| | - Dmitriy Vinogradov
- Hospital Therapy Department No. 2, I.M. Sechenov First Moscow State Medical University, RF Health Ministry, Bolshaya Pirogovskaya St. 2, Bld. 4, 119435 Moscow, Russia
| | - Yulia Chabaeva
- National Medical Research Center for Hematology, Novy Zykovski Lane 4a, 125167 Moscow, Russia
| | - Sergey Kulikov
- National Medical Research Center for Hematology, Novy Zykovski Lane 4a, 125167 Moscow, Russia
| | - Tatiana Makarik
- National Medical Research Center for Hematology, Novy Zykovski Lane 4a, 125167 Moscow, Russia
| | - Vahe Margaryan
- Hospital Therapy Department No. 2, I.M. Sechenov First Moscow State Medical University, RF Health Ministry, Bolshaya Pirogovskaya St. 2, Bld. 4, 119435 Moscow, Russia
| | - Georgiy Manasyan
- Hospital Therapy Department No. 2, I.M. Sechenov First Moscow State Medical University, RF Health Ministry, Bolshaya Pirogovskaya St. 2, Bld. 4, 119435 Moscow, Russia
| | - Veronika Novikova
- Hospital Therapy Department No. 2, I.M. Sechenov First Moscow State Medical University, RF Health Ministry, Bolshaya Pirogovskaya St. 2, Bld. 4, 119435 Moscow, Russia
| | - Svetlana Rachina
- Hospital Therapy Department No. 2, I.M. Sechenov First Moscow State Medical University, RF Health Ministry, Bolshaya Pirogovskaya St. 2, Bld. 4, 119435 Moscow, Russia
| | | | - Karine Lytkina
- War Veterans Hospital N3, Startovaya St. 4, 129336 Moscow, Russia
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Kiraz A, Sezer O, Alemdar A, Canbek S, Duman N, Bisgin A, Cora T, Ruhi HI, Ergoren MC, Geçkinli BB, Sag SO, Gözden HE, Oz O, Altıntaş ZM, Yalcıntepe S, Keskin A, Tak AY, Paskal ŞA, Yürekli UF, Demirtas M, Evren EU, Hanta A, Başdemirci M, Suer K, Balta B, Kocak N, Karabulut HG, Cobanogulları H, Ateş EA, Bozdoğan ST, Eker D, Ekinci S, Nergiz S, Tuncalı T, Yagbasan S, Alavanda C, Kutlay NY, Evren H, Erdoğan M, Altıner S, Sanlidag T, Gonen GA, Vicdan A, Eras N, Eker HK, Balasar O, Tuncel G, Dundar M, Gurkan H, Temel SG. Contribution of genotypes in Prothrombin and Factor V Leiden to COVID-19 and disease severity in patients at high risk for hereditary thrombophilia. J Med Virol 2023; 95:e28457. [PMID: 36597901 DOI: 10.1002/jmv.28457] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2022] [Revised: 12/23/2022] [Accepted: 12/30/2022] [Indexed: 01/05/2023]
Abstract
Thrombotic and microangiopathic effects have been reported in COVID-19 patients. This study examined the contribution of the hereditary thrombophilia factors Prothrombin (FII) and Factor V Leiden (FVL) genotypes to the severity of COVID-19 disease and the development of thrombosis. This study investigated FII and FVL alleles in a cohort of 9508 patients (2606 male and 6902 female) with thrombophilia. It was observed that 930 of these patients had been infected by SARS-CoV-2 causing COVID-19. The demographic characteristics of the patients and their COVID-19 medical history were recorded. Detailed clinical manifestations were analyzed in a group of cases (n = 4092). This subgroup was age and gender-matched. FII and FVL frequency data of healthy populations without thrombophilia risk were obtained from Bursa Uludag University Medical Genetic Department's Exome Databank. The ratio of males (31.08%; 27.01%) and the mean age (36.85 ± 15.20; 33.89 ± 14.14) were higher among COVID-19 patients compared to non-COVID-19 patients. The prevalence of FVL and computerized tomography (CT) positivity in COVID-19 patients was statistically significant in the thrombotic subgroup (p < 0.05). FVL prevalence, CT positivity rate, history of thrombosis, and pulmonary thromboembolism complication were found to be higher in deceased COVID-19 patients (p < 0.05). Disease severity was mainly affected by FVL and not related to genotypes at the Prothrombin mutations. Overall, disease severity and development of thrombosis in COVID-19 are mainly affected by the variation within the FVL gene. Possible FVL mutation should be investigated in COVID-19 patients and appropriate treatment should be started earlier in FVL-positive patients.
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Affiliation(s)
- Aslıhan Kiraz
- Kayseri City Training and Research Hospital, Genetic Diseases Evaluation Center, Kayseri, Turkey
| | - Ozlem Sezer
- Samsun Training and Research Hospital, Genetic Diseases Evaluation Center, Samsun, Turkey
| | - Adem Alemdar
- Department of Translational Medicine, Institute of Health Sciences, Bursa Uludag University, Bursa, Turkey
| | - Sezin Canbek
- Umraniye Training and Research Hospital, Genetic Diseases Evaluation Center, Health Sciences University, Istanbul, Turkey
| | - Nilgun Duman
- Department of Medical Genetics, Dragos Hospital, Bezmialem Vakıf University, Istanbul, Turkey
| | - Atıl Bisgin
- Medical Genetics Department of Medical Faculty, AGENTEM (Adana Genetic Diseases Diagnosis and Treatment Center), Cukurova University, Adana, Turkey
| | - Tulin Cora
- Department of Medical Genetics, Faculty of Medicine, Selcuk University, Konya, Turkey
| | - Hatice Ilgın Ruhi
- Department of Medical Genetics, Faculty of Medicine, Ankara University, Ankara, Turkey
| | - Mahmut Cerkez Ergoren
- Department of Medical Genetics, Faculty of Medicine, Near East University, Nicosia, Cyprus
| | - Bilgen Bilge Geçkinli
- Department of Medical Genetics, Faculty of Medicine, Marmara University, Istanbul, Turkey
| | - Sebnem Ozemri Sag
- Department of Medical Genetics, Faculty of Medicine, Bursa Uludag University, Bursa, Turkey
| | - Hilmi Erdem Gözden
- Department of Translational Medicine, Institute of Health Sciences, Bursa Uludag University, Bursa, Turkey.,Department of Haematology, Bursa Yuksek Ihtısas Training and Research Hospital, Health Sciences University, Bursa, Turkey
| | - Ozlem Oz
- Department of Medical Genetics, Faculty of Medicine, Harran University, Sanlıurfa, Turkey
| | - Zuhal Mert Altıntaş
- Department of Medical Genetics, Faculty of Medicine, Mersin University, Mersin, Turkey
| | - Sinem Yalcıntepe
- Department of Medical Genetics, Faculty of Medicine, Trakya University, Edirne, Turkey
| | - Adem Keskin
- Department of Biochemistry, Institute of Health Sciences, Adnan Menderes University, Aydın, Turkey
| | - Ayşegül Yabacı Tak
- Department of Biostatistics and Medical Informatics, Faculty of Medicine, Bezmialem Vakıf University, Istanbul, Turkey
| | - Şeyma Aktaş Paskal
- Department of Medical Genetics, Faculty of Medicine, Erciyes University, Kayseri, Turkey
| | - Uğur Fahri Yürekli
- Department of Medical Biochemistry, Sanlıurfa Mehmet Akif İnan Health Application and Research Center, Health Sciences University, Sanlıurfa, Turkey
| | | | - Emine Unal Evren
- Department of Infectious Diseases and Clinical Microbiology, Faculty of Medicine, University of Kyrenia, Kyrenia, Cyprus
| | - Abdullah Hanta
- Cukurova University AGENTEM (Adana Genetic Diseases Diagnosis and Treatment Center), Adana, Turkey
| | - Müşerref Başdemirci
- Konya Training and Research Hospital, Genetic Diseases Evaluation Center, Health Sciences University, Konya, Turkey
| | - Kaya Suer
- Department of Infectious Diseases and Clinicai Microbiology, Faculty of Medicine, Near East University, Nicosia, Cyprus
| | - Burhan Balta
- Kayseri City Training and Research Hospital, Genetic Diseases Evaluation Center, Kayseri, Turkey
| | - Nadir Kocak
- Department of Medical Genetics, Faculty of Medicine, Selcuk University, Konya, Turkey
| | | | | | - Esra Arslan Ateş
- Department of Medical Genetics, Faculty of Medicine, Marmara University, Istanbul, Turkey
| | - Sevcan Tuğ Bozdoğan
- Medical Genetics Department of Medical Faculty, AGENTEM (Adana Genetic Diseases Diagnosis and Treatment Center), Cukurova University, Adana, Turkey
| | - Damla Eker
- Department of Medical Genetics, Faculty of Medicine, Trakya University, Edirne, Turkey
| | - Sadiye Ekinci
- Department of Medical Genetics, Faculty of Medicine, Ankara University, Ankara, Turkey
| | - Süleyman Nergiz
- Department of Medical Genetics, Faculty of Medicine, Selcuk University, Konya, Turkey
| | - Timur Tuncalı
- Department of Medical Genetics, Faculty of Medicine, Ankara University, Ankara, Turkey
| | - Serap Yagbasan
- Department of Medical Genetics, Faculty of Medicine, Erciyes University, Kayseri, Turkey
| | - Ceren Alavanda
- Department of Medical Genetics, Faculty of Medicine, Marmara University, Istanbul, Turkey
| | - Nuket Yurur Kutlay
- Department of Medical Genetics, Faculty of Medicine, Ankara University, Ankara, Turkey
| | - Hakan Evren
- Department of Infectious Diseases and Clinical Microbiology, Faculty of Medicine, University of Kyrenia, Kyrenia, Cyprus
| | - Murat Erdoğan
- Kayseri City Training and Research Hospital, Genetic Diseases Evaluation Center, Kayseri, Turkey
| | - Sule Altıner
- Department of Medical Genetics, Faculty of Medicine, Ankara University, Ankara, Turkey
| | | | - Gizem Akıncı Gonen
- Kayseri City Training and Research Hospital, Genetic Diseases Evaluation Center, Kayseri, Turkey
| | - Arzu Vicdan
- Department of Medical Genetics, Faculty of Medicine, Ankara University, Ankara, Turkey
| | - Nazan Eras
- Department of Medical Genetics, Faculty of Medicine, Mersin University, Mersin, Turkey
| | - Hatice Koçak Eker
- Konya Training and Research Hospital, Genetic Diseases Evaluation Center, Health Sciences University, Konya, Turkey
| | - Ozgür Balasar
- Konya Training and Research Hospital, Genetic Diseases Evaluation Center, Health Sciences University, Konya, Turkey
| | - Gulten Tuncel
- DESAM Institute, Near East University, Nicosia, Cyprus
| | - Munis Dundar
- Department of Medical Genetics, Faculty of Medicine, Erciyes University, Kayseri, Turkey
| | - Hakan Gurkan
- Department of Medical Genetics, Faculty of Medicine, Trakya University, Edirne, Turkey
| | - Sehime Gulsun Temel
- Department of Translational Medicine, Institute of Health Sciences, Bursa Uludag University, Bursa, Turkey.,Department of Medical Genetics, Faculty of Medicine, Bursa Uludag University, Bursa, Turkey.,Department of Medical Genetics, Health Sciences Institute, Baskent University, Ankara, Turkey
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