Background Thrombotic consequences have been reported in COVID-19-infected patients, especially those who are critically ill. Multiple studies have tested antiphospholipid antibodies (aPLs) among COVID-19 patients, but to date, the actual frequency of aPLs is still uncharted. In this cohort study, we analyzed the outcomes of 173 consecutive patients with confirmed COVID-19 infection. Anti-phospholipid antibodies, which include anti-cardiolipin antibodies [aCL (IgM), aCL (IgG)], and B2-glycoprotein I antibodies [aβ2GPI (IgM), aβ2GPI (IgG)] were detected by using immunoassays. In contrast, lupus anti-coagulant (LAC) antibodies are identified through a coagulation-based assay. Results The study demonstrated a high incidence of thrombotic consequences in severe COVID pneumonia cases and supported an increased risk of developing aPLs following COVID-19 infection. Pulmonary embolism had the most common prevalence of all thrombotic events. Among the various aPLs tested in thrombotic patients, lupus anti-coagulant (LAC) had the highest positivity (46.2%). Most patients with arterial thromboembolism (stroke, myocardial infarction, limb ischemia, bowel ischemia, and renal artery thrombosis) had triple positivity of anti-phospholipid antibodies. Testing aPLs antibodies after 12 weeks of recovery for survived patients only 2 out of 23 patients had aPLs positivity compared to 35 out of 65 tested during hospital admission. Furthermore, we found no significant changes in aPLs positivity between survived and non-survived patients with thrombotic event. Conclusions aPLs increased transiently as an inflammatory-mediated condition. Individuals with aPLs triple positivity (positive LAC, aCL, and aB2GPI) had a considerable risk of arterial thromboembolism (ATE).
【저자키워드】 COVID-19, Venous Thromboembolism, severe pneumonia, Anti-phospholipid antibodies, arterial thromboembolism, 【초록키워드】 antibodies, IgM, thrombosis, antibody, stroke, risk, outcome, cohort study, Prevalence, immunoassays, Testing, Critically ill, COVID-19 infection, Pulmonary embolism, Patient, Thromboembolism, Hospital admission, COVID pneumonia, incidence, Myocardial infarction, Thrombotic events, patients, COVID-19 patients, Ischemia, Frequency, increased risk, individual, thrombotic, Confirmed COVID-19 infection, renal, positive, Multiple, bowel, consequence, limb, Result, highest, tested, significant changes in, analyzed, include, reported, Most patient, supported, demonstrated, survived, anti-cardiolipin antibody, consecutive patient, 【제목키워드】 Severe COVID-19 pneumonia, antibody, Thromboembolic event,