High production MBL2 polymorphisms protect against COVID-19 complications in critically ill patients: A retrospective cohort study.

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.
Competing Interests: The authors declare the following financial interests/personal relationships which may be considered as potential competing interests:Rodrigo Feliciano do Carmo reports financial support was provided by Foundation for Support of Science and Technology of Pernambuco State. Rodrigo Feliciano do Carmo reports financial support was provided by Coordination of Higher Education Personnel Improvement. Anderson da Costa Armstrong reports financial support was provided by Secretaria Estadual de Saúde de Pernambuco. Associate editor at Heliyon - RFC.
(© 2023 The Authors. Published by Elsevier Ltd.)