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Antiphospholipid Antibodies in Critically Ill Patients With COVID-19.
Xiao, Meng; Zhang, Yan; Zhang, Shulan; Qin, Xuzhen; Xia, Peng; Cao, Wei; Jiang, Wei; Chen, Huan; Ding, Xin; Zhao, Hua; Zhang, Hongmin; Wang, Chunyao; Zhao, Jing; Sun, Xuefeng; Tian, Ran; Wu, Wei; Wu, Dong; Ma, Jie; Chen, Yu; Zhang, Dong; Xie, Jing; Yan, Xiaowei; Zhou, Xiang; Liu, Zhengyin; Wang, Jinglan; Du, Bin; Qin, Yan; Gao, Peng; Lu, Minya; Hou, Xin; Wu, Xian; Zhu, Huadong; Xu, Yingchun; Zhang, Wen; Li, Taisheng; Zhang, Fengchun; Zhao, Yongqiang; Li, Yongzhe; Zhang, Shuyang.
  • Xiao M; Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China.
  • Zhang Y; Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China.
  • Zhang S; Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China.
  • Qin X; Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China.
  • Xia P; Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China.
  • Cao W; Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China.
  • Jiang W; Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China.
  • Chen H; Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China.
  • Ding X; Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China.
  • Zhao H; Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China.
  • Zhang H; Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China.
  • Wang C; Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China.
  • Zhao J; Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China.
  • Sun X; Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China.
  • Tian R; Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China.
  • Wu W; Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China.
  • Wu D; Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China.
  • Ma J; Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China.
  • Chen Y; Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China.
  • Zhang D; Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China.
  • Xie J; Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China.
  • Yan X; Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China.
  • Zhou X; Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China.
  • Liu Z; Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China.
  • Wang J; Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China.
  • Du B; Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China.
  • Qin Y; Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China.
  • Gao P; Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China.
  • Lu M; Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China.
  • Hou X; Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China.
  • Wu X; Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China.
  • Zhu H; Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China.
  • Xu Y; Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China.
  • Zhang W; Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China.
  • Li T; Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China.
  • Zhang F; Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China.
  • Zhao Y; Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China.
  • Li Y; Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China.
  • Zhang S; Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China.
Arthritis Rheumatol ; 72(12): 1998-2004, 2020 12.
Artículo en Inglés | MEDLINE | ID: covidwho-880254
ABSTRACT

OBJECTIVE:

Coagulopathy is one of the characteristics observed in critically ill patients with coronavirus disease 2019 (COVID-19). Antiphospholipid antibodies (aPLs) contribute to coagulopathy, though their role in COVID-19 remains unclear. This study was undertaken to determine the prevalence and characteristics of aPLs in patients with COVID-19.

METHODS:

Sera collected from 66 COVID-19 patients who were critically ill and 13 COVID-19 patients who were not critically ill were tested by chemiluminescence immunoassay for anticardiolipin antibodies (aCLs), anti-ß2 -glycoprotein I (anti-ß2 GPI) (IgG, IgM, and IgA), and IgG anti-ß2 GPI-domain 1 (anti-ß2 GPI-D1) and IgM and IgG anti-phosphatidylserine/prothrombin (anti-PS/PT) antibodies were detected in the serum by enzyme-linked immunosorbent assay.

RESULTS:

Of the 66 COVID-19 patients in critical condition, aPLs were detected in 31 (47% ). Antiphospholipid antibodies were not present among COVID-19 patients who were not in critical condition. The IgA anti-ß2 GPI antibody was the most commonly observed aPL in patients with COVID-19 and was present in 28.8% (19 of 66) of the critically ill patients, followed by IgA aCLs (17 of 66, or 25.8%) and IgG anti-ß2 GPI (12 of 66, or 18.2%). For multiple aPLs, IgA anti-ß2 GPI + IgA aCLs was the most common antibody profile observed (15 of 66, or 22.7%), followed by IgA anti-ß2 GPI + IgA aCL + IgG anti-ß2 GPI (10 of 66, or 15.2%). Antiphospholipid antibodies emerge ~35-39 days after disease onset. A dynamic analysis of aPLs revealed 4 patterns based on the persistence or transient appearance of the aPLs. Patients with multiple aPLs had a significantly higher incidence of cerebral infarction compared to patients who were negative for aPLs (P = 0.023).

CONCLUSION:

Antiphospholipid antibodies were common in critically ill patients with COVID-19. Repeated testing demonstrating medium to high titers of aPLs and the number of aPL types a patient is positive for may help in identifying patients who are at risk of developing cerebral infarction. Antiphospholipid antibodies may be transient and disappear within a few weeks, but in genetically predisposed patients, COVID-19 may trigger the development of an autoimmune condition similar to the antiphospholipid syndrome (APS), referred to as "COVID-19-induced APS-like syndrome." Long-term follow-up of COVID-19 patients who are positive for aPLs would be of great importance in understanding the pathogenesis of this novel coronavirus.
Asunto(s)

Texto completo: Disponible Colección: Bases de datos internacionales Base de datos: MEDLINE Asunto principal: Enfermedad Crítica / Anticuerpos Antifosfolípidos / COVID-19 Tipo de estudio: Estudio de cohorte / Estudio observacional / Estudio pronóstico Límite: Adolescente / Adulto / Anciano / Femenino / Humanos / Masculino / Middle aged / Young_adult Idioma: Inglés Revista: Arthritis Rheumatol Año: 2020 Tipo del documento: Artículo País de afiliación: Art.41425

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Texto completo: Disponible Colección: Bases de datos internacionales Base de datos: MEDLINE Asunto principal: Enfermedad Crítica / Anticuerpos Antifosfolípidos / COVID-19 Tipo de estudio: Estudio de cohorte / Estudio observacional / Estudio pronóstico Límite: Adolescente / Adulto / Anciano / Femenino / Humanos / Masculino / Middle aged / Young_adult Idioma: Inglés Revista: Arthritis Rheumatol Año: 2020 Tipo del documento: Artículo País de afiliación: Art.41425