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Bararu Bojan I, Dobreanu S, Vladeanu MC, Ciocoiu M, Badescu C, Plesoianu C, Filip N, Iliescu D, Frasinariu O, Bojan A, Tudor R, Badulescu OV. The Etiology of the Thrombotic Phenomena Involved in the Process of Coronary Artery Disease-What Is the Role of Thrombophilic Genes in the Development of This Pathology? Int J Mol Sci 2024; 25:5228. [PMID: 38791267 PMCID: PMC11120830 DOI: 10.3390/ijms25105228] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2024] [Revised: 05/06/2024] [Accepted: 05/08/2024] [Indexed: 05/26/2024] Open
Abstract
Cardiovascular diseases, among which includes coronary artery disease, represent one of the most important causes of mortality and morbidity worldwide. Research aimed at determining the risk factors involved recognizes a group of "traditional" risk factors, but also more recent studies identified over 100 "novel" ones which may have a role in the disease. Among the latter is the thrombophilia profile of a patient, a pathology well-established for its involvement in venous thromboembolism, but with less studied implications in arterial thrombosis. This paper reviews the literature, explaining the pathophysiology of the thrombophilia causes associated most with coronary thrombosis events. Results of several studies on the subject, including a meta-analysis with over 60,000 subjects, determined the significant involvement of factor V Leiden, prothrombin G20210A mutation, plasminogen activator inhibitor-1 and antiphospholipid syndrome in the development of coronary artery disease. The mechanisms involved are currently at different stages of research, with some already established and used as therapeutic targets.
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Affiliation(s)
- Iris Bararu Bojan
- Department of Pathophysiology, University of Medicine and Pharmacy Gr. T. Popa, 700115 Iași, Romania; (I.B.B.); (N.F.); (O.V.B.)
| | - Stefan Dobreanu
- Recuperare Hospital Iasi, University of Medicine and Pharmacy Gr. T. Popa, 700115 Iași, Romania (C.B.)
| | - Maria Cristina Vladeanu
- Department of Pathophysiology, University of Medicine and Pharmacy Gr. T. Popa, 700115 Iași, Romania; (I.B.B.); (N.F.); (O.V.B.)
| | - Manuela Ciocoiu
- Department of Pathophysiology, University of Medicine and Pharmacy Gr. T. Popa, 700115 Iași, Romania; (I.B.B.); (N.F.); (O.V.B.)
| | - Codruta Badescu
- Recuperare Hospital Iasi, University of Medicine and Pharmacy Gr. T. Popa, 700115 Iași, Romania (C.B.)
| | - Carmen Plesoianu
- Department of Internal Medicine, University of Medicine and Pharmacy Gr. T. Popa, 700115 Iași, Romania
| | - Nina Filip
- Department of Pathophysiology, University of Medicine and Pharmacy Gr. T. Popa, 700115 Iași, Romania; (I.B.B.); (N.F.); (O.V.B.)
| | - Dan Iliescu
- Department of Internal Medicine, University of Medicine and Pharmacy Gr. T. Popa, 700115 Iași, Romania
| | - Otilia Frasinariu
- Department of Pediatry, University of Medicine and Pharmacy Gr. T. Popa, 700115 Iași, Romania
| | - Andrei Bojan
- Department of Surgical Sciences, University of Medicine and Pharmacy Gr. T. Popa, 700115 Iași, Romania
| | - Razvan Tudor
- Department of Orthopedy, University of Medicine and Pharmacy Gr. T. Popa, 700115 Iași, Romania
| | - Oana Viola Badulescu
- Department of Pathophysiology, University of Medicine and Pharmacy Gr. T. Popa, 700115 Iași, Romania; (I.B.B.); (N.F.); (O.V.B.)
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Badulescu OV, Badescu MC, Bojan IB, Vladeanu M, Filip N, Dobreanu S, Tudor R, Ciuntu BM, Tanevski A, Ciocoiu M. Thrombotic Disease in Hemophilic Patients: Is This a Paradox in a State of Hypocoagulability? Diagnostics (Basel) 2024; 14:286. [PMID: 38337802 PMCID: PMC10854955 DOI: 10.3390/diagnostics14030286] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2023] [Revised: 01/20/2024] [Accepted: 01/23/2024] [Indexed: 02/12/2024] Open
Abstract
Hemophilia patients have a deficiency in or dysfunction of clotting factors, which can lead to a bleeding tendency. However, paradoxically, some hemophilia patients may also be at an increased risk of developing thrombotic events such as deep vein thrombosis or pulmonary embolism. The pathophysiology of thrombosis in hemophilia patients is not fully understood, but it is thought to involve a complex interplay of various factors, including the severity of the hemophilia, the presence of other risk factors such as obesity, smoking, or the use of hormonal therapies, and the presence of certain genetic mutations that increase the risk of thrombosis. In addition, it has been suggested that the use of clotting factor replacement therapy, which is a standard treatment for hemophilia, may also contribute to the development of thrombosis in some cases.
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Affiliation(s)
- Oana Viola Badulescu
- Department of Pathophysiology, Morpho-Functional Sciences (II), Faculty of Medicine, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iasi, Romania; (O.V.B.); (M.V.); (M.C.)
| | - Minerva Codruta Badescu
- Department of Internal Medicine, Faculty of Medicine, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iasi, Romania
| | - Iris Bararu Bojan
- Department of Pathophysiology, Morpho-Functional Sciences (II), Faculty of Medicine, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iasi, Romania; (O.V.B.); (M.V.); (M.C.)
| | - Maria Vladeanu
- Department of Pathophysiology, Morpho-Functional Sciences (II), Faculty of Medicine, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iasi, Romania; (O.V.B.); (M.V.); (M.C.)
| | - Nina Filip
- Department of Biochemistry, Morpho-Functional Sciences (II), Faculty of Medicine, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iasi, Romania;
| | - Stefan Dobreanu
- Institute of Cardiovascular Diseases, G.I.M. Georgescu, 700503 Iasi, Romania
| | - Razvan Tudor
- Department of Orthopedics and Traumatology, Surgical Science (II), Faculty of Medicine, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iasi, Romania;
| | - Bogdan-Mihnea Ciuntu
- Department of General Surgery, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iași, Romania; (B.-M.C.); (A.T.)
| | - Adelina Tanevski
- Department of General Surgery, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iași, Romania; (B.-M.C.); (A.T.)
| | - Manuela Ciocoiu
- Department of Pathophysiology, Morpho-Functional Sciences (II), Faculty of Medicine, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iasi, Romania; (O.V.B.); (M.V.); (M.C.)
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Ceylan AC, Çavdarlı B, Ceylan GG, Topçu V, Satılmış SBA, Bektaş ŞG, Kalem AK, Kayaaslan B, Eser F, Kalkan EA, İnan O, Hasanoğlu İ, Yüksel S, Ateş İ, İzdeş S, Güner R, Gündüz CNS. Impact of Inflammation-Related Genes on COVID-19: Prospective Study at Turkish Cohort. TOHOKU J EXP MED 2023; 261:179-185. [PMID: 37635061 DOI: 10.1620/tjem.2023.j071] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/29/2023]
Abstract
The pandemic coronavirus disease 2019 (COVID-19) has caused a high mortality rate and poses a significant threat to the population. The disease may progress with mild symptoms or may cause the need for intensive care, depending on many factors. In this study, it was aimed to determine if there is a tendency due to genetic factors in COVID-19 patients. Ninety-four of 188 patients with mild clinical and 94 with severe clinical symptoms were included in the study. The targeted panel including coagulopathy (F2, F5), viral invasion (ACE2), and inflammation (CXCL8, IFNAR2, IFNL4, IL10, IL2, IL6, IRF7, TLR3, TLR7, TNF) related genes was performed sequenced by the next generation sequencing (NGS). The variants found were classified and univariate analyses were performed to select candidate variables for logistic model. Risk factors and variants were compared. It was revealed that the presence of 2 or more risk factors caused the disease to progress severely (p < 0.001). Heterozygous IRF7:c.1357-23dup variant had a 2.5 times higher risk for mild disease compared to severe disease. Other variants were found to be more significant in mild disease. Since polymorphic variants were not evaluated in the literature, the findings of our study could not be compared with the literature. However, as variants that may be effective in the severity of infections may differ according to ethnicity. This study has the feature of being a guide for subsequent studies to be carried out especially in Turkish population. Clinical course of the COVID-19 is likely to depend on a variety of risk factors, including age, sex, clinical status, immunology and genetic factors.
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Affiliation(s)
- Ahmet Cevdet Ceylan
- Department of Medical Genetics, Faculty of Medicine, Ankara Yıldırım Beyazıt University
- Department of Medical Genetics, Ankara City Hospital
| | | | - Gülay Güleç Ceylan
- Department of Medical Genetics, Faculty of Medicine, Ankara Yıldırım Beyazıt University
- Department of Medical Genetics, Ankara City Hospital
| | - Vehap Topçu
- Department of Medical Genetics, Ankara City Hospital
| | | | | | - Ayşe K Kalem
- Department of Infectious Diseases and Clinical Microbiology, Faculty of Medicine, Ankara Yıldırım Beyazıt University
- Department of Infectious Diseases and Clinical Microbiology, Ankara City Hospital
| | - Bircan Kayaaslan
- Department of Infectious Diseases and Clinical Microbiology, Faculty of Medicine, Ankara Yıldırım Beyazıt University
- Department of Infectious Diseases and Clinical Microbiology, Ankara City Hospital
| | - Fatma Eser
- Department of Infectious Diseases and Clinical Microbiology, Faculty of Medicine, Ankara Yıldırım Beyazıt University
- Department of Infectious Diseases and Clinical Microbiology, Ankara City Hospital
| | | | - Osman İnan
- Department of Internal Medicine, Ankara City Hospital
| | - İmran Hasanoğlu
- Department of Infectious Diseases and Clinical Microbiology, Faculty of Medicine, Ankara Yıldırım Beyazıt University
- Department of Infectious Diseases and Clinical Microbiology, Ankara City Hospital
| | - Selcen Yüksel
- Department of Biostatistics, Ankara Yıldırım Beyazıt University
| | - İhsan Ateş
- Department of Internal Medicine, Ankara City Hospital, Health Science University
| | - Seval İzdeş
- Department of Anesthesiology and Reanimation-Critical Care, Ankara City Hospital
- Department of Anesthesiology and Reanimation-Critical Care, Faculty of Medicine, Ankara Yıldırım Beyazıt University
| | - Rahmet Güner
- Department of Infectious Diseases and Clinical Microbiology, Faculty of Medicine, Ankara Yıldırım Beyazıt University
- Department of Infectious Diseases and Clinical Microbiology, Ankara City Hospital
| | - C Nur Semerci Gündüz
- Department of Medical Genetics, Faculty of Medicine, Ankara Yıldırım Beyazıt University
- Department of Medical Genetics, Ankara City Hospital
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Sekulovski M, Mileva N, Chervenkov L, Peshevska-Sekulovska M, Vasilev GV, Vasilev GH, Miteva D, Tomov L, Lazova S, Gulinac M, Velikova T. Endothelial Dysfunction and Pregnant COVID-19 Patients with Thrombophilia: A Narrative Review. Biomedicines 2023; 11:2458. [PMID: 37760899 PMCID: PMC10525846 DOI: 10.3390/biomedicines11092458] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2023] [Revised: 08/22/2023] [Accepted: 09/02/2023] [Indexed: 09/29/2023] Open
Abstract
Pregnancy with SARS-CoV-2 infection can raise the risk of many complications, including severe COVID-19 and maternal-fetal adverse outcomes. Additionally, endothelial damage occurs as a result of direct SARS-CoV-2 infection, as well as immune system, cardiovascular, and thrombo-inflammatory reactions. In this narrative review, we focus on endothelial dysfunction (ED) in pregnancy, associated with obstetric complications, such as preeclampsia, fetal growth retardation, gestational diabetes, etc., and SARS-CoV-2 infection in pregnant women that can cause ED itself and overlap with other pregnancy complications. We also discuss some shared mechanisms of SARS-CoV-2 pathophysiology and ED.
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Affiliation(s)
- Metodija Sekulovski
- Department of Anesthesiology and Intensive Care, University Hospital Lozenetz, 1 Kozyak Str., 1407 Sofia, Bulgaria
- Medical Faculty, Sofia University, St. Kliment Ohridski, Kozyak 1 Str., 1407 Sofia, Bulgaria; (M.P.-S.); (G.V.V.); (G.H.V.); (D.M.); (L.T.); (S.L.); (M.G.); (T.V.)
| | - Niya Mileva
- Medical Faculty, Medical University of Sofia, 1 Georgi Sofiiski Str., 1431 Sofia, Bulgaria;
| | - Lyubomir Chervenkov
- Department of Diagnostic Imaging, Medical University Plovdiv, Bul. Vasil Aprilov 15A, 4000 Plovdiv, Bulgaria;
| | - Monika Peshevska-Sekulovska
- Medical Faculty, Sofia University, St. Kliment Ohridski, Kozyak 1 Str., 1407 Sofia, Bulgaria; (M.P.-S.); (G.V.V.); (G.H.V.); (D.M.); (L.T.); (S.L.); (M.G.); (T.V.)
- Department of Gastroenterology, University Hospital Lozenetz, 1407 Sofia, Bulgaria
| | - Georgi Vasilev Vasilev
- Medical Faculty, Sofia University, St. Kliment Ohridski, Kozyak 1 Str., 1407 Sofia, Bulgaria; (M.P.-S.); (G.V.V.); (G.H.V.); (D.M.); (L.T.); (S.L.); (M.G.); (T.V.)
- Clinic of Endocrinology and Metabolic Disorders, UMHAT “Sv. Georgi”, 4000 Plovdiv, Bulgaria
| | - Georgi Hristov Vasilev
- Medical Faculty, Sofia University, St. Kliment Ohridski, Kozyak 1 Str., 1407 Sofia, Bulgaria; (M.P.-S.); (G.V.V.); (G.H.V.); (D.M.); (L.T.); (S.L.); (M.G.); (T.V.)
- Laboratory of Hematopathology and Immunology, National Specialized Hospital for Active Treatment of Hematological Diseases, “Plovdivsko Pole“ Str., 6, 1756 Sofia, Bulgaria
| | - Dimitrina Miteva
- Medical Faculty, Sofia University, St. Kliment Ohridski, Kozyak 1 Str., 1407 Sofia, Bulgaria; (M.P.-S.); (G.V.V.); (G.H.V.); (D.M.); (L.T.); (S.L.); (M.G.); (T.V.)
- Department of Genetics, Faculty of Biology, Sofia University “St. Kliment Ohridski”, 8 Dragan Tzankov Str., 1164 Sofia, Bulgaria
| | - Latchezar Tomov
- Medical Faculty, Sofia University, St. Kliment Ohridski, Kozyak 1 Str., 1407 Sofia, Bulgaria; (M.P.-S.); (G.V.V.); (G.H.V.); (D.M.); (L.T.); (S.L.); (M.G.); (T.V.)
- Department of Informatics, New Bulgarian University, Montevideo 21 Str., 1618 Sofia, Bulgaria
| | - Snezhina Lazova
- Medical Faculty, Sofia University, St. Kliment Ohridski, Kozyak 1 Str., 1407 Sofia, Bulgaria; (M.P.-S.); (G.V.V.); (G.H.V.); (D.M.); (L.T.); (S.L.); (M.G.); (T.V.)
- Pediatric Clinic, University Hospital “N. I. Pirogov,” 21 “General Eduard I. Totleben” Blvd; 1606 Sofia, Bulgaria
- Department of Healthcare, Faculty of Public Health “Prof. Tsekomir Vodenicharov, MD, DSc”, Medical University of Sofia, Bialo More 8 Str., 1527 Sofia, Bulgaria
| | - Milena Gulinac
- Medical Faculty, Sofia University, St. Kliment Ohridski, Kozyak 1 Str., 1407 Sofia, Bulgaria; (M.P.-S.); (G.V.V.); (G.H.V.); (D.M.); (L.T.); (S.L.); (M.G.); (T.V.)
- Department of General and Clinical Pathology, Medical University of Plovdiv, Bul. Vasil Aprilov 15A, 4000 Plovdiv, Bulgaria
| | - Tsvetelina Velikova
- Medical Faculty, Sofia University, St. Kliment Ohridski, Kozyak 1 Str., 1407 Sofia, Bulgaria; (M.P.-S.); (G.V.V.); (G.H.V.); (D.M.); (L.T.); (S.L.); (M.G.); (T.V.)
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Chirumamilla Y, Almerstani Y, Marcus H, Bachuwa G. Protein S Deficiency and COVID-19: A Brutal Combination Leading to Acute Submassive Bilateral Pulmonary Embolism. Cureus 2023; 15:e41560. [PMID: 37554606 PMCID: PMC10405865 DOI: 10.7759/cureus.41560] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/08/2023] [Indexed: 08/10/2023] Open
Abstract
Protein S deficiency is a form of inherited thrombophilia that occurs due to low levels of or improper function of protein S. The role of protein S is to inactivate procoagulant factors, and a deficiency results in an increased risk of thrombotic events. The coronavirus disease 2019 (COVID-19) infection has also been studied to increase the risk of venous thromboembolism (VTE) due to an interplay of several mechanisms. However, the risk of VTE in patients affected by both of these disease processes simultaneously has not been thoroughly studied, and so recommendations regarding routine screening and prophylaxis of VTE have also not been established. We discuss the case of a 46-year-old woman with a past history of protein S deficiency and a recent COVID-19 infection who presented with complaints of shortness of breath. Upon examination, she was found to be hypoxic and tachycardic. A computed tomography angiography of the chest was done and revealed acute submassive bilateral pulmonary embolism with right heart strain and pulmonary infarcts. She was initially treated with intravenous heparin and later transitioned to oral anticoagulation for a minimum of six months.
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Affiliation(s)
| | | | - Huda Marcus
- Internal Medicine, Michigan State University College of Human Medicine, Flint, USA
| | - Ghassan Bachuwa
- Internal Medicine, Hurley Medical Center, Michigan State University College of Human Medicine, Flint, USA
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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: 3] [Impact Index Per Article: 3.0] [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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8
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Filip N, Cojocaru E, Badulescu OV, Clim A, Pinzariu AC, Bordeianu G, Jehac AE, Iancu CE, Filip C, Maranduca MA, Sova IA, Serban IL. SARS-CoV-2 Infection: What Is Currently Known about Homocysteine Involvement? Diagnostics (Basel) 2022; 13:10. [PMID: 36611302 PMCID: PMC9818222 DOI: 10.3390/diagnostics13010010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2022] [Revised: 12/12/2022] [Accepted: 12/16/2022] [Indexed: 12/24/2022] Open
Abstract
Since December 2019, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has spread rapidly throughout the world causing health, social and economic instability. The severity and prognosis of patients with SARS-CoV-2 infection are associated with the presence of comorbidities such as cardiovascular disease, hypertension, chronic lung disease, cerebrovascular disease, diabetes, chronic kidney disease, and malignancy. Thrombosis is one of the most serious complications that can occur in patients with COVID-19. Homocysteine is a non-proteinogenic α-amino acid considered a potential marker of thrombotic diseases. Our review aims to provide an updated analysis of the data on the involvement of homocysteine in COVID-19 to highlight the correlation of this amino acid with disease severity and the possible mechanisms by which it intervenes.
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Affiliation(s)
- Nina Filip
- Department of Morpho-Functional Sciences (II), Discipline of Biochemistry, Faculty of Medicine, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iasi, Romania
| | - Elena Cojocaru
- Department of Morpho-Functional Sciences (I), Discipline of Morphopathology, Faculty of Medicine, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iasi, Romania
| | - Oana Viola Badulescu
- Department of Morpho-Functional Sciences (II), Discipline of Pathophysiology, Faculty of Medicine, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iasi, Romania
| | - Andreea Clim
- Department of Morpho-Functional Sciences (II), Discipline of Physiology, Faculty of Medicine, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iasi, Romania
| | - Alin Constantin Pinzariu
- Department of Morpho-Functional Sciences (II), Discipline of Physiology, Faculty of Medicine, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iasi, Romania
| | - Gabriela Bordeianu
- Department of Morpho-Functional Sciences (II), Discipline of Biochemistry, Faculty of Medicine, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iasi, Romania
| | - Alina Elena Jehac
- Department of Dentoalveolar and Maxillofacial Surgery, Faculty of Dental Medicine, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iasi, Romania
| | - Cristina Elena Iancu
- Department of Biochemistry, Faculty of Pharmacy, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iasi, Romania
| | - Cristiana Filip
- Department of Morpho-Functional Sciences (II), Discipline of Biochemistry, Faculty of Medicine, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iasi, Romania
| | - Minela Aida Maranduca
- Department of Morpho-Functional Sciences (II), Discipline of Physiology, Faculty of Medicine, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iasi, Romania
| | - Ivona Andreea Sova
- IOSUD Faculty of Medicine, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iasi, Romania
| | - Ionela Lacramioara Serban
- Department of Morpho-Functional Sciences (II), Discipline of Physiology, Faculty of Medicine, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iasi, Romania
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9
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Di Micco P, Annunziata A, Fiorentino G. Editorial Comment on Special Issue—COVID-19 after One Year of Clinical Experience: Unexpected Clinical Presentations or Complications and Post-COVID-19 Clinical Features. Healthcare (Basel) 2022; 10:healthcare10091715. [PMID: 36141327 PMCID: PMC9498340 DOI: 10.3390/healthcare10091715] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2022] [Accepted: 09/05/2022] [Indexed: 11/20/2022] Open
Affiliation(s)
- Pierpaolo Di Micco
- UOC Medicina, PO A. Rizzoli, ASL Napoli 2 Nord, Lacco Ameno, 80076 Naples, Italy
- Correspondence:
| | - Anna Annunziata
- Department of Respiratory Pathophysiology and Rehabilitation Monaldi–A.O. Dei Colli, 80131 Naples, Italy
| | - Giuseppe Fiorentino
- Department of Respiratory Pathophysiology and Rehabilitation Monaldi–A.O. Dei Colli, 80131 Naples, Italy
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Hemoperitoneum as a Life-Threatening Complication of an Acute Cholecystitis in a Patient with Hemophilia A with Inhibitors: A Case Report. Healthcare (Basel) 2022; 10:healthcare10091652. [PMID: 36141264 PMCID: PMC9498687 DOI: 10.3390/healthcare10091652] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2022] [Revised: 08/22/2022] [Accepted: 08/28/2022] [Indexed: 12/02/2022] Open
Abstract
We present the case of a 52-year-old male with severe hemophilia A with inhibitors, who was diagnosticated with acute lithiasic cholecystitis that required surgical intervention due to lack of favorable response to conservatory treatment. During surgery, hemostatic support was performed with activated recombinant factor VII (rFVIIa, NovoSeven®). The surgery was performed first laparoscopically with adhesiolysis, followed by subcostal laparotomy and cholecystectomy because of the findings of a pericholecystic plastron with abscess and massive inflammatory anatomical modifications. The patient presented postoperative complications, requiring a second surgical intervention, due to the installation of a hemoperitoneum. Hemostatic treatment with rFVIIa was given for a further 3 weeks postoperatively, and the patient was discharged in safe condition. A surgical intervention increases the risk of bleeding in hemophilic patients, which may have vital complications in the absence of adequate hemostatic support and the support of a multidisciplinary team with experience in hemophilic surgery.
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