{"doi":"10.1101/2021.10.12.464152","title":"SARS-CoV-2 spike protein induces abnormal inflammatory blood clots neutralized by fibrin immunotherapy","abstract":"Blood clots are a central feature of coronavirus disease-2019 (COVID-19) and can culminate in pulmonary embolism, stroke, and sudden death. However, it is not known how abnormal blood clots form in COVID-19 or why they occur even in asymptomatic and convalescent patients. Here we report that the Spike protein from severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) binds to the blood coagulation factor fibrinogen and induces structurally abnormal blood clots with heightened proinflammatory activity. SARS-CoV-2 Spike virions enhanced fibrin-mediated microglia activation and induced fibrinogen-dependent lung pathology. COVID-19 patients had fibrin autoantibodies that persisted long after acute infection. Monoclonal antibody 5B8, targeting the cryptic inflammatory fibrin epitope, inhibited thromboinflammation. Our results reveal a procoagulant role for the SARS-CoV-2 Spike and propose fibrin-targeting interventions as a treatment for thromboinflammation in COVID-19. ONE-SENTENCE SUMMARY: SARS-CoV-2 spike induces structurally abnormal blood clots and thromboinflammation neutralized by a fibrin-targeting antibody.","journal":"bioRxiv (Cold Spring Harbor Laboratory)","year":2021,"id":213206,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":31,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.9614,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2021-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":257374,"name":"Elif G. Sözmen","orcid":null,"position":1,"is_corresponding":false},{"id":451303,"name":"Karuna Dixit","orcid":"0000-0003-3583-2512","position":2,"is_corresponding":false},{"id":28877,"name":"Mauricio Montaño","orcid":"0000-0002-0353-0037","position":3,"is_corresponding":false},{"id":374969,"name":"Yusuke Matsui","orcid":"0000-0002-6016-2867","position":4,"is_corresponding":false},{"id":63565,"name":"Yixin Liu","orcid":"0000-0001-9043-3691","position":5,"is_corresponding":false},{"id":805061,"name":"Ekram Helmy","orcid":null,"position":6,"is_corresponding":false},{"id":699331,"name":"Thomas J. Deerinck","orcid":"0000-0002-1696-8409","position":7,"is_corresponding":false},{"id":246277,"name":"Zhaoqi Yan","orcid":"0000-0001-9326-2920","position":8,"is_corresponding":false},{"id":733012,"name":"Renaud Schuck","orcid":null,"position":9,"is_corresponding":false},{"id":257377,"name":"Rosa Meza Acevedo","orcid":null,"position":10,"is_corresponding":false},{"id":804540,"name":"Collin M. Spencer","orcid":"0000-0002-3999-7499","position":11,"is_corresponding":false},{"id":71688,"name":"Reuben Thomas","orcid":"0000-0003-3176-7303","position":12,"is_corresponding":false},{"id":246283,"name":"Alexander R. Pico","orcid":"0000-0001-5706-2163","position":13,"is_corresponding":false},{"id":246282,"name":"Scott S. Zamvil","orcid":"0000-0003-2720-9915","position":14,"is_corresponding":false},{"id":235421,"name":"Kara L. Lynch","orcid":"0000-0003-1367-0401","position":15,"is_corresponding":false},{"id":227589,"name":"Mark H. Ellisman","orcid":"0000-0001-8893-8455","position":16,"is_corresponding":false},{"id":28871,"name":"Warner C. Greene","orcid":"0000-0001-9896-8615","position":17,"is_corresponding":false},{"id":246285,"name":"Katerina Akassoglou","orcid":"0000-0002-2632-1465","position":18,"is_corresponding":false},{"id":246269,"name":"Jae Kyu Ryu","orcid":"0000-0002-3992-4011","position":0,"is_corresponding":true}],"reference_count":33,"raw_metadata":null,"created_at":"2026-07-18T23:52:31.378994Z","pmid":"34671772","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}