Antiphospholipid antibodies and vitamin D deficiency in COVID-19 infection with and without venous or arterial thrombosis: A pilot case-control study.

BACKGROUND: Coronavirus disease-2019 (COVID-19) is associated with thromboembolism. Antiphospholipid antibody (APLa) formation is one of the mechanisms. Vitamin D deficiency has been associated with thrombosis in antiphospholipid antibody syndrome. OBJECTIVE: Measure APLa and vitamin D in hospitalized COVID-19 patients with and without thrombosis to evaluate if thromboembolism is associated with concomitant APLa and vitamin D deficiency. METHODS: Case-control study. Hospitalized COVID-19 patients with a thromboembolic event (ischemic stroke, myocardial infarction, deep venous thrombosis/pulmonary embolism, Cases n = 20). Controls (n = 20): Age, sex-matched without thromboembolic events. Patients with autoimmune disorders, antiphospholipid antibody syndrome, thrombophilia, anticoagulation therapy, prior thromboembolism, chronic kidney disease 3b, 4, end-stage renal disease, and malignancy were excluded. Given the limited current literature on the role of concomitant antiphospholipid antibodies and vitamin D deficiency in causing venous and/or arterial thrombosis in hospitalized COVID-19 patients, we enrolled 20 patients in each arm. Anti-cardiolipin IgG/IgM, beta-2 glycoprotein-1 IgG/IgM, lupus anticoagulant and vitamin D levels were measured in both groups. RESULTS: Cases were 5.7 times more likely to be vitamin D deficient (OR:5.7, 95% CI:1.3-25.6) and 7.4 times more likely to have any one APLa (OR:7.4, 95% CI: 1.6-49.5) while accounting for the effects of sex. Patients with both APLa and vitamin D deficiency had significantly more thrombosis compared to patients who were antibody positive without vitamin D deficiency (100% vs 47.4%; p = 0.01). CONCLUSIONS: Thrombosis in COVID-19 was associated with concomitant APLa and vitamin D deficiency. Future studies in COVID-19 should assess the role of vitamin D in reducing thrombosis.

Spatial frequency tuning reveals interactions between the dorsal and ventral visual systems.

It is widely argued that the ability to recognize and identify manipulable objects depends on the retrieval and simulation of action-based information associated with using those objects. Evidence for that view comes from fMRI studies that have reported differential BOLD contrast in dorsal visual stream regions when participants view manipulable objects compared with a range of baseline categories. An alternative interpretation is that processes internal to the ventral visual pathway are sufficient to support the visual identification of manipulable objects and that the retrieval of object-associated use information is contingent on analysis of the visual input by the ventral stream. Here, we sought to distinguish these two perspectives by exploiting the fact that the dorsal stream is largely driven by magnocellular input, which is biased toward low spatial frequency visual information. Thus, any tool-selective responses in parietal cortex that are driven by high spatial frequencies would be indicative of inputs from the ventral visual pathway. Participants viewed images of tools and animals containing only low, or only high, spatial frequencies during fMRI. We find an internal parcellation of left parietal "tool-preferring" voxels: Inferior aspects of left parietal cortex are driven by high spatial frequency information and have privileged connectivity with ventral stream regions that show similar category preferences, whereas superior regions are driven by low spatial frequency information. Our findings suggest that the automatic activation of complex object-associated manipulation knowledge is contingent on analysis of the visual input by the ventral visual pathway.