Thrombophilia genetic mutations and their relation to disease severity among patients with COVID-19

PLoS One. 2024 Mar 20;19(3):e0296668. doi: 10.1371/journal.pone.0296668. eCollection 2024.

Abstract

Objectives: Patients with COVID-19 infection appear to develop virus-induced hypercoagulability resulting in numerous thrombotic events. The aim of the present study was to determine the relationship between the thrombophilia genes mutations (prothrombin G20210A, factor V Leiden, and methyltetrahydrofolate reductase (MTHFR)) and the severity of COVID-19 patients.

Design: Prospective cross-sectional study.

Method: One hundred and forty patients (80 adults and 60 children) were included in the current study. They were divided into the severe COVID-19 group and the mild COVID-19 group, with each group comprising 40 adults and 30 children. The patients were assessed for FV R506Q, FV R2H1299R, MTHFR A1298C, MTHFR C677T, and prothrombin gene G20210A polymorphisms. CBC, D-dimer, renal and liver function tests, hs-CRP, ferritin, and LDH were also assessed. Thrombotic events were clinically and radiologically documented.

Results: Severe COVID-19 cases were significantly more frequent to have a heterozygous mutation for all the studied genes compared to mild COVID-19 cases (p<0.05 for all). Being mutant to gene FV R506Q carried the highest risk of developing a severe disease course (p<0.0001). Patients with abnormally high D-dimer levels were significantly more frequent to be heterozygous for FV R506Q, FV R2H1299R, and prothrombin gene G20210A (p = 0.006, 0.007, and 0.02, respectively).

Conclusion: We concluded that there is an evident relationship between severe COVID-19 and inherited thrombophilia. In the current study, FV R506Q gene mutation carried the highest risk of developing a severe COVID-19 disease course.

MeSH terms

  • Adult
  • COVID-19* / genetics
  • Child
  • Cross-Sectional Studies
  • Factor V / genetics
  • Humans
  • Methylenetetrahydrofolate Reductase (NADPH2) / genetics
  • Mutation
  • Patient Acuity
  • Prospective Studies
  • Prothrombin / genetics
  • Thrombophilia* / complications
  • Thrombophilia* / genetics
  • Thrombosis* / genetics

Substances

  • Prothrombin
  • Methylenetetrahydrofolate Reductase (NADPH2)
  • Factor V

Supplementary concepts

  • Thrombophilia, hereditary

Grants and funding

The authors received no specific funding for this work.