Apparent different of lupus anticoagulant disappearance in novel coronavirus 2019 patients as a distinct clinical feature

ABSTRACT

Background: SARS-CoV-2 was reported to affect hemostasis, and thrombosis laboratory indices but its effect on lupus anticoagulant remains controversial. Aims: The purpose of this study is to learn more about the properties of lupus anticoagulant in patients with COVID-19 in Korea. Methods: We retrospectively searched for COVID-19 confirmed patients at the Asan Medical Center from March 2020 to February 2021. Medical chart review was conducted to collect their clinical information and hematology laboratory data. Among 142 confirmed patients, 67 patients with lupus anticoagulant testing were included to determine the differences in laboratory indices, especially LA. Results: Most of the patients in our study had mild clinical courses. Lupus anticoagulant was identified in 67.8% of survivors and 25.0% of deaths. In the LA confirmatory test, 97.5% DRVVT and 10.0% SCT positivity were found. Among 40 LA-positive patients, 13 patients were lost for follow up, and 12 patients were unable to determine time-lapse until negative transition of LA. Of the 15 patients who had serial follow-up LA test data, 10 patients (66.7%) were found with rapid disappearance within 6 weeks and 4 case (26.7%) of negative conversion within 6 to 12 weeks. Most of cases (93.3%) disappearance of LA less than 12 weeks. There were no other antiphospholipid syndrome-related antibodies, such as anti-cardiolipin antibodies or anti-beta-2-gylcoprotein, except for 2 of the 40 patients who were LA positive. FIGURE 1 Classification of COVID-19 patients based on Lupus anticoagulant test TABLE 1 Hematology laboratory parameters of COVID-19 patients based on Lupus anticoagulant test Conclusions: As previously reported, LA was found in a high proportion of COVID-19 patients. This is the first study to confirm that the proportion of LA positivity (67.8%) is high in Korean COVID patients. Most LA positivity disappeared within 12 weeks (93.3%). The clinical significance of high LA positive rates and rapid negative transitions in COVID-19 patients is currently unknown, but needs confirmation.