Patients with COVID-19 who are very sick are more likely to get blood clots in their lungs if they have a gene variant in their natural immune system. Researchers from Uppsala University and Karolinska Institutet have shown this in a new study that has just been published in Nature Immunology.

“With this study,” according to Oskar Eriksson, one of the study’s main authors, “we are a step closer in explaining why COVID-19 patients have a substantially increased risk of blood clots.”

During the pandemic, it became clear that patients with COVID-19 had a significantly elevated risk of blood clots, even when treated with blood thinners. It’s unclear why COVID-19 causes such a significant activation of the blood’s coagulation system in some patients.

Researchers at Uppsala University and Karolinska Institutet have found that a gene variant that controls the amount of a protein in the blood called mannose-binding lectin protects against blood clots in the lungs.

Understands the coronavirus

The natural immune system has a mannose-binding lectin. It detects and removes bacteria and virus-infected cells. Another study (Stravalaci et al., Nature Immunology, issue 23, pages 275–286 (2022) found that the mannose-binding lectin recognizes the SARS-CoV-2 virus that produces COVID-19 and may neutralize infected cells.

“We can now show how mannose-binding lectin influences the course of the illness COVID-19. It is striking that it is the risk for blood clots that is impacted,” explains Oskar Eriksson, “and we could not see that mannose-binding lectin influences the risk of becoming ill with COVID-19.

“We can show that the immune system is important for blood clot formation in COVID-19 patients, something that was long suspected and that can explain why such high doses of blood thinners have been necessary.”

Large studies presented in recent year have discovered multiple gene variants that influence the chance of becoming extremely unwell from COVID-19.

This new study, according to Hugo Zeberg, co-responsible for the study, “shows that there is also a genetic background for which complications affect COVID-19 patients.”

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