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Lupus Anticoagulant Single Positivity During the Acute Phase of COVID-19 Is Not Associated With Venous Thromboembolism or In-Hospital Mortality.
Gendron, Nicolas; Dragon-Durey, Marie-Agnès; Chocron, Richard; Darnige, Luc; Jourdi, Georges; Philippe, Aurélien; Chenevier-Gobeaux, Camille; Hadjadj, Jérôme; Duchemin, Jérôme; Khider, Lina; Yatim, Nader; Goudot, Guillaume; Krzisch, Daphné; Debuc, Benjamin; Mauge, Laetitia; Levavasseur, Françoise; Pene, Frédéric; Boussier, Jeremy; Sourdeau, Elise; Brichet, Julie; Ochat, Nadège; Goulvestre, Claire; Peronino, Christophe; Szwebel, Tali-Anne; Pages, Franck; Gaussem, Pascale; Samama, Charles-Marc; Cheurfa, Cherifa; Planquette, Benjamin; Sanchez, Olivier; Diehl, Jean-Luc; Mirault, Tristan; Fontenay, Michaela; Terrier, Benjamin; Smadja, David M.
  • Gendron N; Université de Paris, Innovative Therapies in Haemostasis, INSERM, F-75006, and Hematology Department and Biosurgical Research Lab (Carpentier Foundation), Assistance Publique Hôpitaux de Paris. Centre-Université de Paris (APHP-CUP), F-75015, Paris, France.
  • Dragon-Durey MA; Centre de Recherche des Cordeliers, Sorbonne Université, INSERM, Université de Paris, Team Inflammation, Complement and Cancer, F-75006, and Immunology Department, Georges Pompidou European Hospital, APHP-CUP, F-75015, Paris, France.
  • Chocron R; Université de Paris, PARCC, INSERM, F-75015, and Emergency Department, APHP-CUP, F-75015, Paris, France.
  • Darnige L; Université de Paris, Innovative Therapies in Haemostasis, INSERM, F-75006, and Hematology Department and Biosurgical Research Lab (Carpentier Foundation), Assistance Publique Hôpitaux de Paris. Centre-Université de Paris (APHP-CUP), F-75015, Paris, France.
  • Jourdi G; Université de Paris, Innovative Therapies in Haemostasis, INSERM, F-75006, and Hematology Department, APHP-CUP, F-75014, Paris, France.
  • Philippe A; Université de Paris, Innovative Therapies in Haemostasis, INSERM, F-75006, and Hematology Department and Biosurgical Research Lab (Carpentier Foundation), Assistance Publique Hôpitaux de Paris. Centre-Université de Paris (APHP-CUP), F-75015, Paris, France.
  • Chenevier-Gobeaux C; Department of Automated Diagnostic Biology, Hôpital Cochin, APHP-CUP, F-75014, Paris, France.
  • Hadjadj J; Université de Paris Imagine Institute, Laboratory of Immunogenetics of Pediatric Autoimmune Diseases, INSERM UMR 1163, F-75015, and Paris Department of Internal Medicine, National Referral Center for Rare Systemic Autoimmune Diseases, APHP-CUP, F-75014, Paris, France.
  • Duchemin J; Université de Paris, Innovative Therapies in Haemostasis, INSERM, F-75006, and Hematology Department, APHP-CUP, F-75014, Paris, France.
  • Khider L; Université de Paris, Vascular Medicine Department and Biosurgical Research Lab (Carpentier Foundation), APHP-CUP, F-75015, Paris, France.
  • Yatim N; Translational Immunology Lab, Department of Immunology, Institut Pasteur, and Department of Internal Medicine, National Referral Center for Rare Systemic Autoimmune Diseases, APHP-CUP, F-75015, Paris, France.
  • Goudot G; Université de Paris, Vascular Medicine Department and Biosurgical Research Lab (Carpentier Foundation), APHP-CUP, F-75015, Paris, France.
  • Krzisch D; Université de Paris, Hematology Department, APHP-CUP, F-75015, Paris, France.
  • Debuc B; Université de Paris, Innovative Therapies in Haemostasis, INSERM, F-75006, and Plastic Surgery Department, APHP-CUP, F-75015, Paris, France.
  • Mauge L; Université de Paris, PARCC, INSERM, F-75015, and Hematology Department, APHP-CUP, F-75015, Paris, France.
  • Levavasseur F; Université de Paris, Institut Cochin, INSERM, F-75014, Paris, France.
  • Pene F; Intensive Care Medicine, APHP-CUP, F-75014, Paris, France.
  • Boussier J; Translational Immunology Lab, Department of Immunology, Institut Pasteur, and Department of Internal Medicine, National Referral Center for Rare Systemic Autoimmune Diseases, APHP-CUP, F-75015, Paris, France.
  • Sourdeau E; Université de Paris, Innovative Therapies in Haemostasis, INSERM, F-75006, and Hematology Department, APHP-CUP, F-75014, Paris, France.
  • Brichet J; Université de Paris, Hematology Department, APHP-CUP, F-75015, Paris, France.
  • Ochat N; Université de Paris, Hematology Department, APHP-CUP, F-75015, Paris, France.
  • Goulvestre C; Immunology Department, APHP-CUP, F-75014, Paris, France.
  • Peronino C; Université de Paris, Innovative Therapies in Haemostasis, INSERM, F-75006, and Hematology Department and Biosurgical Research Lab (Carpentier Foundation), Assistance Publique Hôpitaux de Paris. Centre-Université de Paris (APHP-CUP), F-75015, Paris, France.
  • Szwebel TA; Translational Immunology Lab, Department of Immunology, Institut Pasteur, and Department of Internal Medicine, National Referral Center for Rare Systemic Autoimmune Diseases, APHP-CUP, F-75015, Paris, France.
  • Pages F; Centre de Recherche des Cordeliers, Sorbonne Université, INSERM, Université de Paris, Team Inflammation, Complement and Cancer, F-75006, and Immunology Department, Georges Pompidou European Hospital, APHP-CUP, F-75015, Paris, France.
  • Gaussem P; Université de Paris, Innovative Therapies in Haemostasis, INSERM, F-75006, and Hematology Department, APHP-CUP, F-75014, Paris, France.
  • Samama CM; Université de Paris, Innovative Therapies in Haemostasis, INSERM, F-75006, and Anaesthesia, Intensive Care and Perioperative Medicine Department, APHP-CUP, F-75014, Paris, France.
  • Cheurfa C; Anaesthesia, Intensive Care and Perioperative Medicine Department, APHP-CUP, F-75014, Paris, France.
  • Planquette B; Université de Paris, Innovative Therapies in Haemostasis, INSERM, F-75006, and Respiratory Medicine Department and Biosurgical Research Lab (Carpentier Foundation), APHP-CUP, F-75015 Paris, France and F-CRIN INNOVTE, Saint-Étienne, France.
  • Sanchez O; Université de Paris, Innovative Therapies in Haemostasis, INSERM, F-75006, and Respiratory Medicine Department and Biosurgical Research Lab (Carpentier Foundation), APHP-CUP, F-75015 Paris, France and F-CRIN INNOVTE, Saint-Étienne, France.
  • Diehl JL; Université de Paris, Innovative Therapies in Haemostasis, INSERM, F-75006, and Intensive Care Unit and Biosurgical Research Lab (Carpentier Foundation), APHP-CUP, F-75015, Paris, France.
  • Mirault T; Université de Paris, Vascular Medicine Department and Biosurgical Research Lab (Carpentier Foundation), APHP-CUP, F-75015, Paris, France.
  • Fontenay M; Université de Paris, Institut Cochin, INSERM, and Hematology Department, APHP-CUP, F-75014, Paris, France.
  • Terrier B; Université de Paris, PARCC, INSERM U970, F-75015, and Department of Internal Medicine, National Referral Center for Rare Systemic Autoimmune Diseases, APHP-CUP, F-75014, Paris, France.
  • Smadja DM; Université de Paris, Innovative Therapies in Haemostasis, INSERM, F-75006, and Hematology Department and Biosurgical Research Lab (Carpentier Foundation), APHP-CUP, F-75015 Paris, France and F-CRIN INNOVTE, Saint-Étienne, France.
Arthritis Rheumatol ; 73(11): 1976-1985, 2021 11.
Article in English | MEDLINE | ID: covidwho-1432359
Semantic information from SemMedBD (by NLM)
1. Lupus Coagulation Inhibitor NEG_ASSOCIATED_WITH Venous Thromboembolism
Subject
Lupus Coagulation Inhibitor
Predicate
NEG_ASSOCIATED_WITH
Object
Venous Thromboembolism
2. Lupus Coagulation Inhibitor ASSOCIATED_WITH COVID-19
Subject
Lupus Coagulation Inhibitor
Predicate
ASSOCIATED_WITH
Object
COVID-19
3. COVID-19 PROCESS_OF Patients
Subject
COVID-19
Predicate
PROCESS_OF
Object
Patients
4. Patients LOCATION_OF Antiphospholipid Antibodies
Subject
Patients
Predicate
LOCATION_OF
Object
Antiphospholipid Antibodies
5. High Level PROCESS_OF Patients
Subject
High Level
Predicate
PROCESS_OF
Object
Patients
6. vinyltriethoxysilane NEG_COEXISTS_WITH Lupus Coagulation Inhibitor
Subject
vinyltriethoxysilane
Predicate
NEG_COEXISTS_WITH
Object
Lupus Coagulation Inhibitor
7. Lupus Coagulation Inhibitor NEG_ASSOCIATED_WITH Venous Thromboembolism
Subject
Lupus Coagulation Inhibitor
Predicate
NEG_ASSOCIATED_WITH
Object
Venous Thromboembolism
8. Lupus Coagulation Inhibitor ASSOCIATED_WITH COVID-19
Subject
Lupus Coagulation Inhibitor
Predicate
ASSOCIATED_WITH
Object
COVID-19
9. COVID-19 PROCESS_OF Patients
Subject
COVID-19
Predicate
PROCESS_OF
Object
Patients
10. Patients LOCATION_OF Antiphospholipid Antibodies
Subject
Patients
Predicate
LOCATION_OF
Object
Antiphospholipid Antibodies
11. High Level PROCESS_OF Patients
Subject
High Level
Predicate
PROCESS_OF
Object
Patients
12. vinyltriethoxysilane NEG_COEXISTS_WITH Lupus Coagulation Inhibitor
Subject
vinyltriethoxysilane
Predicate
NEG_COEXISTS_WITH
Object
Lupus Coagulation Inhibitor
ABSTRACT

OBJECTIVE:

The clinical relevance of antiphospholipid antibodies (aPLs) in COVID-19 is controversial. This study was undertaken to investigate the prevalence and prognostic value of conventional and nonconventional aPLs in patients with COVID-19.

METHODS:

This was a multicenter, prospective observational study in a French cohort of patients hospitalized with suspected COVID-19.

RESULTS:

Two hundred forty-nine patients were hospitalized with suspected COVID-19, in whom COVID-19 was confirmed in 154 and not confirmed in 95. We found a significant increase in lupus anticoagulant (LAC) positivity among patients with COVID-19 compared to patients without COVID-19 (60.9% versus 23.7%; P < 0.001), while prevalence of conventional aPLs (IgG and IgM anti-ß2 -glycoprotein I and IgG and IgM anticardiolipin isotypes) and nonconventional aPLs (IgA isotype of anticardiolipin, IgA isotype of anti-ß2 -glycoprotein I, IgG and IgM isotypes of anti-phosphatidylserine/prothrombin, and IgG and IgM isotypes of antiprothrombin) was low in both groups. Patients with COVID-19 who were positive for LAC, as compared to patients with COVID-19 who were negative for LAC, had higher levels of fibrinogen (median 6.0 gm/liter [interquartile range 5.0-7.0] versus 5.3 gm/liter [interquartile range 4.3-6.4]; P = 0.028) and C-reactive protein (CRP) (median 115.5 mg/liter [interquartile range 66.0-204.8] versus 91.8 mg/liter [interquartile range 27.0-155.1]; P = 0.019). Univariate analysis did not show any association between LAC positivity and higher risks of venous thromboembolism (VTE) (odds ratio 1.02 [95% confidence interval 0.44-2.43], P = 0.95) or in-hospital mortality (odds ratio 1.80 [95% confidence interval 0.70-5.05], P = 0.24). With and without adjustment for CRP level, age, and sex, Kaplan-Meier survival curves according to LAC positivity confirmed the absence of an association with VTE or in-hospital mortality (unadjusted P = 0.64 and P = 0.26, respectively; adjusted hazard ratio 1.13 [95% confidence interval 0.48-2.60] and 1.80 [95% confidence interval 0.67-5.01], respectively).

CONCLUSION:

Patients with COVID-19 have an increased prevalence of LAC positivity associated with biologic markers of inflammation. However, LAC positivity at the time of hospital admission is not associated with VTE risk and/or in-hospital mortality.
Subject(s)

Full text: Available Collection: International databases Database: MEDLINE Main subject: Lupus Coagulation Inhibitor / Venous Thromboembolism / COVID-19 Type of study: Controlled clinical trial / Etiology study / Observational study / Prognostic study / Randomized controlled trials / Risk factors Topics: Long Covid Limits: Aged / Female / Humans / Male / Middle aged Language: English Journal: Arthritis Rheumatol Year: 2021 Document Type: Article Affiliation country: Art.41777

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Lupus Coagulation Inhibitor / Venous Thromboembolism / COVID-19 Type of study: Controlled clinical trial / Etiology study / Observational study / Prognostic study / Randomized controlled trials / Risk factors Topics: Long Covid Limits: Aged / Female / Humans / Male / Middle aged Language: English Journal: Arthritis Rheumatol Year: 2021 Document Type: Article Affiliation country: Art.41777