High production MBL2 polymorphisms protect against COVID-19 complications in critically ill patients: A retrospective cohort study
Lorena Viana de Andrade,
Mirela Vanessa de Souza Sá,
Beatriz Vasconcelos,
Luydson Richardson Silva Vasconcelos,
Ricardo Khouri,
Carlos Dornels Freire de Souza,
Anderson da Costa Armstrong,
Rodrigo Feliciano do Carmo
Affiliations
Lorena Viana de Andrade
Programa de Pós-graduação em Biociências, Universidade Federal do Vale do São Francisco (UNIVASF), Petrolina, Brazil
Mirela Vanessa de Souza Sá
Colegiado de Ciências Farmacêuticas, Universidade Federal do Vale do São Francisco (UNIVASF), Petrolina, Brazil
Beatriz Vasconcelos
Instituto de Pesquisa Gonçalo Moniz, Fundação Oswaldo Cruz (FIOCRUZ), Salvador, Brazil
Luydson Richardson Silva Vasconcelos
Instituto Aggeu Magalhães, Fundação Oswaldo Cruz (FIOCRUZ), Recife, Brazil
Ricardo Khouri
Instituto de Pesquisa Gonçalo Moniz, Fundação Oswaldo Cruz (FIOCRUZ), Salvador, Brazil
Carlos Dornels Freire de Souza
Colegiado de Medicina, Universidade Federal do Vale do São Francisco (UNIVASF), Petrolina, Brazil
Anderson da Costa Armstrong
Colegiado de Medicina, Universidade Federal do Vale do São Francisco (UNIVASF), Petrolina, Brazil
Rodrigo Feliciano do Carmo
Programa de Pós-graduação em Biociências, Universidade Federal do Vale do São Francisco (UNIVASF), Petrolina, Brazil; Colegiado de Ciências Farmacêuticas, Universidade Federal do Vale do São Francisco (UNIVASF), Petrolina, Brazil; Corresponding author. Colegiado de Ciências Farmacêuticas, Universidade Federal do Vale do São Francisco Avenida José de Sá Maniçoba, S/N, Centro, Petrolina 56304-917, Brazil.
Mannose-binding lectin (MBL) binds to SARS-CoV-2, inhibits infection of susceptible cells, and activates the complement system via the lectin pathway. In this study, we investigated the association of MBL2 polymorphisms with the risk of hospitalization and clinical worsening in patients with COVID-19. A total of 550 patients with COVID-19 were included (94 non-hospitalized and 456 hospitalized). Polymorphisms in MBL2 exon 1 (codons 52, 54 and 57) and promoter region (−550, −221, and +4) were determined by real-time PCR. MBL and complement proteins were measured by Luminex. A higher frequency of the H/H genotype and the HYPA haplotype was observed in non-hospitalized patients when compared to hospitalized. In addition, critically ill patients carrying haplotypes associated with high MBL levels (HYPA/HYPA + HYPA/LYPA + HYPA/LYQA + LYPA/LYQA + LYPA/LYPA + LYQA/LYQA + LXPA/HYPA + LXPA/LYQA + LXPA/LYPA) were protected against lower oxygen saturation levels (P = 0.02), use of invasive ventilation use (P = 0.02, OR 0.38), and shock (P = 0.01, OR 0.40), independent of other potential confounders adjusted by multivariate analysis. Our results suggest that variants in MBL2 associated with high MBL levels may play a protective role in the clinical course of COVID-19.
