Lupus anticoagulants as an independent predictor for disease severity in COVID-19 patients

ABSTRACT

Background: Lupus anticoagulants (LA) that appear in antiphospholipid syndrome, known as causes of thrombophilia, are commonly detected during various viral infection. As previously reported, LA is frequently detected in COVID-19 patients who often exhibited thrombosis. However, clinical significance of LA remains unclear, and there are no accurate reports of LA detection patterns. Aim(s) In this study, we performed to analyze clinical significance and detection pattern of LA in COVID-19 patients. Method(s) We performed retrospective chart analysis of COVID-19 patients who underwent LA test at Asan Medical Center from March 2020 to November 2021. We compared laboratory data and disease severity parameters, such as oxygen treatment, between LA-negative and LA-positive groups who detected LA at least once after infection. For LA-positive patients who underwent multiple LA tests, subgroup analysis was performed to determine detection pattern of LA. Result(s) A total of 219 COVID-19 patients were enrolled, 148(67.6%) were LA-positive. LA-positive group more received high flow nasal cannula (p = 0.024). The LA-positive group showed prolonged aPTT, high levels of fibrinogen and CRP (all p's < 0.05). In a subgroup analysis, 127(86.5%) detected LA within 10days of infection and 87(58.8%) were detected LA within 5 days of infection. Among LA-positive patients, 100 were confirmed negative by follow-up test. All 87 patients showed LA-negative conversion within 12 weeks, with exception of 13 patients who underwent follow-up after 12 weeks. The median time to negative conversion was 10 days. Conclusion(s) LA was found in high proportion of COVID-19 patients. LA-positive patients showed higher oxygen demand and higher level of inflammatory parameters. LA is expected to be a predictive indicator of disease severity in COVID-19 patients. LA appears in early stages of infection and disappears rapidly within 10 days in half of cases. Therefore, it is recommended to perform LA test when confirmed COVID-19 infection to predict the course of the disease. (Table Presented).