Anti-Phospholipid Antibodies and COVID-19 Thrombosis: A Co-Star, Not a Supporting Actor.
Biomedicines
; 9(8)2021 Jul 27.
Article
in English
| MEDLINE | ID: covidwho-1334996
ABSTRACT
BACKGROUND:
COVID-19 clinical features include a hypercoagulable state that resembles the antiphospholipid syndrome (APS), a disease characterized by thrombosis and presence of antiphospholipid antibodies (aPL). The relationship between aPL-presence and the appearance of thrombi as well as the transience or permanence of aPL in COVID-19 patients is not sufficiently clear.METHODS:
A group of 360 COVID-19 patients were followed-up for 6 months. Classic aPL, anti-B2GPI IgA, anti-phosphatidylserine/prothrombin IgG/M and anti-SARS-CoV-2 antibodies were determined at acute phase and >12 weeks later. The reference group included 143 healthy volunteers of the same age-range distribution.RESULTS:
aPL prevalence was similar in COVID-19 patients and the reference population. aPL presence in both determinations was significantly associated with thrombosis (OR 2.33 and 3.71), strong agreement being found for classic aPL and anti-B2GPI IgA (Weighted kappa 0.85-0.91). Thrombosis-associated aPL occurred a median of 17 days after hospital admission (IQR 6-28) vs. 4 days for the rest (IQR 3-7). Although anti-SARS-CoV-2 antibodies levels increased during convalescence, aPL hardly changed.CONCLUSIONS:
Most COVID-19 patients would carry these aPL before the infection. At least two mechanisms could be behind thrombosis, early immune-dysregulation-mediated thrombosis after infection and belated-aPL-mediated thrombosis, with SARS-CoV-2 behaving as a second hit.
Full text:
Available
Collection:
International databases
Database:
MEDLINE
Type of study:
Observational study
/
Prognostic study
Language:
English
Year:
2021
Document Type:
Article
Affiliation country:
Biomedicines9080899
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