Contribution of genotypes in Prothrombin and Factor V Leiden to COVID-19 and disease severity in patients at high risk for hereditary thrombophilia.

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.

Can Ferritin Levels Predict the Severity of Illness in Patients With COVID-19?

OBJECTIVES: This study aimed to investigate whether ferritin level can predict the severity of coronavirus disease 2019 (COVID-19). BACKGROUND: The COVID-19 pandemic has been challenging for both patients and caregivers. Many laboratory markers have been used to better understand the causes of poor outcomes and to improve the management of COVID-19 patients. METHODS: A total of 93 patients who had a positive polymerase chain reaction test result for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) were included in this study. Demographic features, comorbidities, clinical and laboratory findings were obtained from the hospital database retrospectively. Patients were divided into two groups according to the disease severity as follows: mild group (n = 70) and severe group (n = 23). RESULTS: The median age of the study population was 42.5 (28.3-62.8) with 69.9% male patients. Patients in the severe group were significantly older and showed a higher frequency of hypertension, diabetes mellitus, coronary artery disease, and heart failure in comparison with those in the mild group. In addition, gamma-glutamyl transferase, C-reactive protein, ferritin, interleukin-6, procalcitonin, and neutrophil to lymphocyte ratio were higher whereas albumin level was lower in patients in the severe group. Linear regression analysis demonstrated that ferritin level was the only significant predictor of disease severity (ß = 0.487, t = 2.993, p = 0.004). In receiver operator characteristics curve analysis, ferritin level ≥264.5 ng/mL predicted severe COVID-19 with a sensitivity of 73.9% and specificity of 94.2%. CONCLUSION: Early analysis of ferritin levels in patients with COVID-19 might effectively predict the disease severity.