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Antiphospholipid antibodies in patients with COVID-19: A relevant observation?
Devreese, Katrien M J; Linskens, Eleni A; Benoit, Dominique; Peperstraete, Harlinde.
  • Devreese KMJ; Coagulation Laboratory, Department of Laboratory Medicine, Ghent University Hospital, Ghent, Belgium.
  • Linskens EA; Department of Diagnostic Sciences, Ghent University, Ghent, Belgium.
  • Benoit D; Coagulation Laboratory, Department of Laboratory Medicine, Ghent University Hospital, Ghent, Belgium.
  • Peperstraete H; Department of Intensive Care Medicine, Ghent University Hospital, Ghent, Belgium.
J Thromb Haemost ; 18(9): 2191-2201, 2020 09.
Article in English | MEDLINE | ID: covidwho-621841
ABSTRACT

BACKGROUND:

High incidence of thrombosis in COVID-19 patients indicates a hypercoagulable state. Hence, exploring the involvement of antiphospholipid antibodies (aPL) in these patients is of interest.

OBJECTIVES:

To illustrate the incidence of criteria (lupus anticoagulant [LAC], anticardiolipin [aCL] immunoglobulin G [IgG]/IgM, antibeta2-glycoprotein I antibodies [aß2GPI] IgG/IgM) and noncriteria (anti-phosphatidyl serine/prothrombin [aPS/PT], aCL, and aß2GPI IgA) aPL in a consecutive cohort of critically ill SARS-CoV-2 patients, their association with thrombosis, antibody profile and titers of aPL. PATIENTS/

METHODS:

Thirty-one consecutive confirmed COVID-19 patients admitted to the intensive care unit were included. aPL were measured at one time point, with part of the aPL-positive patients retested after 1 month.

RESULTS:

Sixteen patients were single LAC-positive, two triple-positive, one double-positive, one single aCL, and three aCL IgG and LAC positive. Seven of nine thrombotic patients had at least one aPL. Sixteen of 22 patients without thrombosis were aPL positive, amongst them two triple positives. Nine of 10 retested LAC-positive patients were negative on a second occasion, as well as the double-positive patient. Seven patients were aPS/PT-positive associated to LAC. Three patients were aCL and aß2GPI IgA-positive.

CONCLUSION:

Our observations support the frequent single LAC positivity during (acute phase) observed in COVID-19 infection; however, not clearly related to thrombotic complications. Triple aPL positivity and high aCL/aß2GPI titers are rare. Repeat testing suggests aPL to be mostly transient. Further studies and international registration of aPL should improve understanding the role of aPL in thrombotic COVID-19 patients.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: Thrombosis / Antibodies, Antiphospholipid / Antibodies, Anticardiolipin / COVID-19 Type of study: Cohort study / Experimental Studies / Observational study / Prognostic study Topics: Long Covid Limits: Adult / Aged / Female / Humans / Male / Middle aged Language: English Journal: J Thromb Haemost Journal subject: Hematology Year: 2020 Document Type: Article Affiliation country: Jth.14994

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Thrombosis / Antibodies, Antiphospholipid / Antibodies, Anticardiolipin / COVID-19 Type of study: Cohort study / Experimental Studies / Observational study / Prognostic study Topics: Long Covid Limits: Adult / Aged / Female / Humans / Male / Middle aged Language: English Journal: J Thromb Haemost Journal subject: Hematology Year: 2020 Document Type: Article Affiliation country: Jth.14994