J Thromb Thrombolysis. 2026 Jul 25. doi: 10.1007/s11239-026-03366-5. Online ahead of print.
ABSTRACT
Hypercoagulability and platelet activation are central components of COVID-19 pathophysiology. However, despite growing evidence that sex-related biological differences may influence thromboinflammatory responses, studies focusing on sex-based genetic variations in coagulation and platelet indices remain limited. This study includes 324 COVID-19 patients, investigated the sex-specific effects of FGB – 455 G > A (rs1800790) and ITGB3 T1565C (rs5918) polymorphisms. Genotypes were determined using TaqMan-based real-time PCR, and patients were stratified by sex; demographic, hematological, and biochemical data were retrieved and analyzed statistically. The GA genotype of FGB rs1800790 was more frequent in females than males, whereas the TC genotype of ITGB3 (rs5918) was less frequent in females (OR = 1.71, 95% CI: 1.06-2.76, p = 0.028; OR = 0.53, 95% CI: 0.31-0.90, p = 0.020, respectively). In the GG genotype of FGB (rs1800790), females were younger and had lower urea, creatinine, and WBC, with no differences in other parameters (p = 0.026, d = 0.367; p = 0.006, d = 0.485; p = 0.012, d = 0.440; and p = 0.010, d = 0.431 respectively). No sex differences were observed in the GA genotype, whereas aPTT was lower in AA-genotype females (p = 0.045, d = 0.830). For ITGB3 (rs5918), males with the TC genotype were older and had higher PT, ferritin, urea, creatinine, and WBC, but lower eosinophils (p = 0.030, d = 0.584; p = 0.042, d = 0.667; p = 0.001, d = 1.081; p = 0.005, d = 0.803; p = 0.020, d = 0.655; p = 0.020, d = 0.609; and p = 0.012, d = 0.733 respectively); the CC genotype was observed only in three males. These results emphasize the combined influence of sex and coagulation-related genetic variants on thrombo-inflammatory patterns in COVID-19. These findings highlight the potential clinical importance of considering sex-genotype interactions when evaluating thrombo-inflammatory responses and may contribute to more personalized risk assessment and management strategies in patients with COVID-19.
PMID:42502144 | DOI:10.1007/s11239-026-03366-5
