Abstract
Background: Reports of severe COVID-19 being associated with thrombosis, antiphospholipid antibodies (APLA), and antiphospholipid syndrome have yielded disparate conclusions. Studies comparing patients with COVID-19 with contemporaneous controls of similar severity are lacking.
Methods: 22 COVID-19 + and 20 COVID-19 – patients with respiratory failure admitted to intensive care were studied longitudinally. Demographic and clinical data were obtained from the day of admission. APLA testing included anticardiolipin (aCL), anti-β2glycoprotien 1 (β2GP1), antidomain 1 β2GP1 and antiphosphatidyl serine/prothrombin complex. Antinuclear antibodies (ANAs) were detected by immunofluorescence and antibodies to cytokines by a commercially available multiplexed array. Analysis of variance was used for continuous variables and Fisher’s exact test was used for categorical variables with α=0.05 and the false discovery rate at q=0.05.
Results: APLAs were predominantly IgG aCL (48%), followed by IgM (21%) in all patients, with a tendency towards higher frequency among the COVID-19 + . aCL was not associated with surrogate markers of thrombosis but IgG aCL was strongly associated with worse disease severity and higher ANA titres regardless of COVID-19 status. An association between aCL and anticytokine autoantibodies tended to be higher among the COVID-19 + .
Conclusions: Positive APLA serology was associated with more severe disease regardless of COVID-19 status.
Trial registration number: NCT04747782 .
Keywords: Covid-19; antibodies; anticardiolipin; antiphospholipid; antiphospholipid syndrome; autoimmunity.
【저자키워드】 COVID-19, antibodies, Autoimmunity, Antiphospholipid syndrome, anticardiolipin, Antiphospholipid, 【초록키워드】 IgG, IgM, Autoimmunity, Respiratory failure, thrombosis, intensive care, severe COVID-19, serology, antibody, severity, disease severity, cytokine, Patient, Control, immunofluorescence, demographic, Admission, patients, association, marker, Frequency, severe disease, autoantibody, false discovery rate, antinuclear antibody, Clinical data, complex, syndrome, titre, report, Fisher, categorical variable, continuous variable, was used, disparate, patients with COVID-19, 【제목키워드】 antibody, Critically ill, Patient, positive,