Observational studyNature medicine2020
Immune complement and coagulation dysfunction in adverse outcomes of SARS-CoV-2 infection.
Observational study in Nature medicine, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 217 papers, 9 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
217 citing papers in PubMed, 9 syntheses or guidelines pooled it, 358 citations in OpenAlex.
- Mucosal immune response in biology, disease prevention and treatment.Signal transduction and targeted therapy · 2025Pooled it
- Risk of Malnutrition in Hospitalized COVID-19 Patients: A Systematic Review and Meta-Analysis.Nutrients · 2022Pooled it
- Tissue factor in COVID-19-associated coagulopathy.Thrombosis research · 2022Pooled it
- COVID-19 and the Immune Response: A Multi-Phasic Approach to the Treatment of COVID-19.International journal of molecular sciences · 2022Pooled it
- Association of Obesity With COVID-19 Severity and Mortality: An Updated Systemic Review, Meta-Analysis, and Meta-Regression.Frontiers in endocrinology · 2022Pooled it
- A systematic meta-analysis of immune signatures in patients with COVID-19.Reviews in medical virology · 2021Pooled it
- Therapeutic Targeting of the Complement System: From Rare Diseases to Pandemics.Pharmacological reviews · 2021Pooled it
- From angiotensin-converting enzyme 2 disruption to thromboinflammatory microvascular disease: A paradigm drawn from COVID-19.International journal of cardiology · 2021Pooled it
- Population risk factors for severe disease and mortality in COVID-19: A global systematic review and meta-analysis.PloS one · 2021Pooled it
- Efficacy and safety of the investigational complement C5 inhibitor zilucoplan in patients hospitalized with COVID-19: an open-label randomized controlled trial.Respiratory research · 2022Trial
- Complement system component dysregulation is a distinctive feature of COVID-19 disease: a prospective and comparative analysis of patients admitted to the emergency department for suspected COVID-19 disease.Journal of thrombosis and thrombolysis · 2022Trial
- Complement Overactivation and Consumption Predicts In-Hospital Mortality in SARS-CoV-2 Infection.Frontiers in immunology · 2021Trial
- Plasma Lectin Pathway Complement Proteins in Patients With COVID-19 and Renal Disease.Frontiers in immunology · 2021Trial
- Survival prediction of colorectal cancer using 101 machine learning methods based on immune-related genes: A machine learning study.Medicine · 2026Article
- Collectin-11, a complement pattern recognition molecule, mediates pulmonary SARS-CoV-2 neutralization and protection.PLoS pathogens · 2026Article
- Renal function dynamics in COVID-19: exploring biomarker interactions with D-dimer and C-reactive proteins.Bioscience reports · 2026Article
- Expression of complement pathway genes is associated with progression of idiopathic pulmonary fibrosis.Respiratory research · 2026Article
- Genetics-mediated regulation of intestinal gene expression on microbiome contributes to human disease heritability.Molecular systems biology · 2026Article
- Complement Hyperactivation Is Mediated by Alternative and Lectin Pathways During Early Phase of Severe Vaccination-Omicron BA.5 Infection.Journal of medical virology · 2026Article
- Predictive biomarkers of COVID-19 impact in renal transplant patients: an exploratory proteomic and cytokine analysis.Frontiers in immunology · 2026Article
157 more citing papers are in PubMed but not listed here.
Corrections and comments
- Update of
Authors and funding
12 authors at 4 institutions in 1 country.
Funding
Abstract
Understanding the pathophysiology of SARS-CoV-2 infection is critical for therapeutic and public health strategies. Viral-host interactions can guide discovery of disease regulators, and protein structure function analysis points to several immune pathways, including complement and coagulation, as targets of coronaviruses. To determine whether conditions associated with dysregulated complement or coagulation systems impact disease, we performed a retrospective observational study and found that history of macular degeneration (a proxy for complement-activation disorders) and history of coagulation disorders (thrombocytopenia, thrombosis and hemorrhage) are risk factors for SARS-CoV-2-associated morbidity and mortality-effects that are independent of age, sex or history of smoking. Transcriptional profiling of nasopharyngeal swabs demonstrated that in addition to type-I interferon and interleukin-6-dependent inflammatory responses, infection results in robust engagement of the complement and coagulation pathways. Finally, in a candidate-driven genetic association study of severe SARS-CoV-2 disease, we identified putative complement and coagulation-associated loci including missense, eQTL and sQTL variants of critical complement and coagulation regulators. In addition to providing evidence that complement function modulates SARS-CoV-2 infection outcome, the data point to putative transcriptional genetic markers of susceptibility. The results highlight the value of using a multimodal analytical approach to reveal determinants and predictors of immunity, susceptibility and clinical outcome associated with infection.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.