SARS-COV-2 causes significant abnormalities in the fibrinolysis system of patients: correlation between viral mutations, variants and thrombosis

BackgroundCoronavirus disease (COVID-19) is reported as a complex disorder affecting multiple systems and coagulopathy that can cause mortality. In this study, we investigated the correlation of SARS-CoV-2 mutations found in blood samples with various changes in the fibrinolysis system, as well as t...

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Main Authors: Esra’a Abudouleh, Tarek Owaidah, Fatimah Alhamlan, Arwa A. Al-Qahtani, Reem M. Aljowaie, Fatimah Al-Ghnnam, Marie Fe Bohol, Ahmed A. Al-Qahtani
Format: Article
Language:English
Published: Frontiers Media S.A. 2025-04-01
Series:Frontiers in Cellular and Infection Microbiology
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Online Access:https://www.frontiersin.org/articles/10.3389/fcimb.2025.1531412/full
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author Esra’a Abudouleh
Tarek Owaidah
Tarek Owaidah
Fatimah Alhamlan
Fatimah Alhamlan
Arwa A. Al-Qahtani
Reem M. Aljowaie
Fatimah Al-Ghnnam
Marie Fe Bohol
Ahmed A. Al-Qahtani
Ahmed A. Al-Qahtani
author_facet Esra’a Abudouleh
Tarek Owaidah
Tarek Owaidah
Fatimah Alhamlan
Fatimah Alhamlan
Arwa A. Al-Qahtani
Reem M. Aljowaie
Fatimah Al-Ghnnam
Marie Fe Bohol
Ahmed A. Al-Qahtani
Ahmed A. Al-Qahtani
author_sort Esra’a Abudouleh
collection DOAJ
description BackgroundCoronavirus disease (COVID-19) is reported as a complex disorder affecting multiple systems and coagulopathy that can cause mortality. In this study, we investigated the correlation of SARS-CoV-2 mutations found in blood samples with various changes in the fibrinolysis system, as well as the severity of the disease based on outcome and whether or not these patients were admitted into the ICU.Materials and methodsCOVID-19 patients (n = 446) admitted to our institute between 2021 and 2022 were recruited. Blood samples were collected, and a sequence analysis of the SARS-CoV-2 spike gene was isolated from the blood. Measured several parameters of fibrinolysis and coagulation, including alpha-2-antiplasmin and plasminogen, thrombin activatable fibrinolysis inhibitor (TAFI), tissue plasminogen activator (tPA), plasminogen activator inhibitor-1 (PAI-1), D-dimer, and fibrinogen levels.ResultsSARS-CoV-2 RNA was found in 123/446 (27.6%) of the blood samples. The N501Y, D614G, K417N, and P681R mutations among COVID-19 patients were associated with higher admissions to the ICU (P = 0.0057, P = 0.0068, P = 0.0193, and P = 0.018, respectively). Omicron (BA.1.1) variant variants are highly associated with thrombosis (P = 0.002) in hospitalized COVID-19 patients that are unvaccinated and have comorbidity conditions. The plasma levels of tPA, aPTT, and D-dimer were significantly higher in participants who had the N501Y mutation (P = 0.044, P = 0.024, and P = 0.027, respectively).ConclusionThrombosis was the most prevalent condition among severe COVID-19 patients. The correlation between specific SARS-CoV-2 new variants and thrombosis warrants more investigation.
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spelling doaj-art-2f44d256ae544ab1909773f8fddea3352025-08-20T02:12:19ZengFrontiers Media S.A.Frontiers in Cellular and Infection Microbiology2235-29882025-04-011510.3389/fcimb.2025.15314121531412SARS-COV-2 causes significant abnormalities in the fibrinolysis system of patients: correlation between viral mutations, variants and thrombosisEsra’a Abudouleh0Tarek Owaidah1Tarek Owaidah2Fatimah Alhamlan3Fatimah Alhamlan4Arwa A. Al-Qahtani5Reem M. Aljowaie6Fatimah Al-Ghnnam7Marie Fe Bohol8Ahmed A. Al-Qahtani9Ahmed A. Al-Qahtani10Department of Botany and Microbiology, College of Science, King Saud University, Riyadh, Saudi ArabiaDepartment of Pathology and Laboratory Medicine, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi ArabiaDepartment of Pathology, College of Medicine, Alfaisal University, Riyadh, Saudi ArabiaDepartment of Infection and Immunity, Research Centre, King Faisal Specialist Hospital & Research Centre, Riyadh, Saudi ArabiaDepartment of Microbiology and Immunology, College of Medicine, Alfaisal University, Riyadh, Saudi ArabiaDepartment of Family Medicine, College of Medicine, Al-Imam Mohammad Ibn Saud Islamic University, Riyadh, Saudi ArabiaDepartment of Botany and Microbiology, College of Science, King Saud University, Riyadh, Saudi ArabiaDepartment of Infection and Immunity, Research Centre, King Faisal Specialist Hospital & Research Centre, Riyadh, Saudi ArabiaDepartment of Infection and Immunity, Research Centre, King Faisal Specialist Hospital & Research Centre, Riyadh, Saudi ArabiaDepartment of Infection and Immunity, Research Centre, King Faisal Specialist Hospital & Research Centre, Riyadh, Saudi ArabiaDepartment of Microbiology and Immunology, College of Medicine, Alfaisal University, Riyadh, Saudi ArabiaBackgroundCoronavirus disease (COVID-19) is reported as a complex disorder affecting multiple systems and coagulopathy that can cause mortality. In this study, we investigated the correlation of SARS-CoV-2 mutations found in blood samples with various changes in the fibrinolysis system, as well as the severity of the disease based on outcome and whether or not these patients were admitted into the ICU.Materials and methodsCOVID-19 patients (n = 446) admitted to our institute between 2021 and 2022 were recruited. Blood samples were collected, and a sequence analysis of the SARS-CoV-2 spike gene was isolated from the blood. Measured several parameters of fibrinolysis and coagulation, including alpha-2-antiplasmin and plasminogen, thrombin activatable fibrinolysis inhibitor (TAFI), tissue plasminogen activator (tPA), plasminogen activator inhibitor-1 (PAI-1), D-dimer, and fibrinogen levels.ResultsSARS-CoV-2 RNA was found in 123/446 (27.6%) of the blood samples. The N501Y, D614G, K417N, and P681R mutations among COVID-19 patients were associated with higher admissions to the ICU (P = 0.0057, P = 0.0068, P = 0.0193, and P = 0.018, respectively). Omicron (BA.1.1) variant variants are highly associated with thrombosis (P = 0.002) in hospitalized COVID-19 patients that are unvaccinated and have comorbidity conditions. The plasma levels of tPA, aPTT, and D-dimer were significantly higher in participants who had the N501Y mutation (P = 0.044, P = 0.024, and P = 0.027, respectively).ConclusionThrombosis was the most prevalent condition among severe COVID-19 patients. The correlation between specific SARS-CoV-2 new variants and thrombosis warrants more investigation.https://www.frontiersin.org/articles/10.3389/fcimb.2025.1531412/fullSARS-CoV2 mutationsSARS-CoV-2 RNAemiathrombosisthrombinplasminogen activator inhibitor (PAI-1)tissue plasminogen activator (tPA)
spellingShingle Esra’a Abudouleh
Tarek Owaidah
Tarek Owaidah
Fatimah Alhamlan
Fatimah Alhamlan
Arwa A. Al-Qahtani
Reem M. Aljowaie
Fatimah Al-Ghnnam
Marie Fe Bohol
Ahmed A. Al-Qahtani
Ahmed A. Al-Qahtani
SARS-COV-2 causes significant abnormalities in the fibrinolysis system of patients: correlation between viral mutations, variants and thrombosis
Frontiers in Cellular and Infection Microbiology
SARS-CoV2 mutations
SARS-CoV-2 RNAemia
thrombosis
thrombin
plasminogen activator inhibitor (PAI-1)
tissue plasminogen activator (tPA)
title SARS-COV-2 causes significant abnormalities in the fibrinolysis system of patients: correlation between viral mutations, variants and thrombosis
title_full SARS-COV-2 causes significant abnormalities in the fibrinolysis system of patients: correlation between viral mutations, variants and thrombosis
title_fullStr SARS-COV-2 causes significant abnormalities in the fibrinolysis system of patients: correlation between viral mutations, variants and thrombosis
title_full_unstemmed SARS-COV-2 causes significant abnormalities in the fibrinolysis system of patients: correlation between viral mutations, variants and thrombosis
title_short SARS-COV-2 causes significant abnormalities in the fibrinolysis system of patients: correlation between viral mutations, variants and thrombosis
title_sort sars cov 2 causes significant abnormalities in the fibrinolysis system of patients correlation between viral mutations variants and thrombosis
topic SARS-CoV2 mutations
SARS-CoV-2 RNAemia
thrombosis
thrombin
plasminogen activator inhibitor (PAI-1)
tissue plasminogen activator (tPA)
url https://www.frontiersin.org/articles/10.3389/fcimb.2025.1531412/full
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