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Lupus Anticoagulant Is Associated with Critical Cases and High Mortality in COVID-19: A Literature Review

Overview
Journal Tanaffos
Specialty Pulmonary Medicine
Date 2023 Nov 3
PMID 37920325
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Abstract

Background: In severe COVID-19 cases, a hypercoagulable state may occur. Antiphospholipid syndrome-related auto-antibodies (APSRAs) contribute to coagulopathy, but their role in COVID- 19 remains unclear. We aimed to investigate the prevalence of positive APSRAs and their effect on clinical outcomes in confirmed COVID-19 patients.

Materials And Methods: In this cross-sectional study, severe hospitalized COVID-19 cases were enrolled. Demographic and clinical data were obtained from the day of admission. APSRAs including IgG and/or IgM anticardiolipin (aCL) and anti-β2-glycoprotein1 (anti-β2GP1) as well as lupus anticoagulant (LAC) were measured.

Results: In this study, 54 severe COVID-19 cases with positive RT-PCR and chest CT scans were recruited. Positive APSRAs were found in 7 (12.9%) patients. Positive LAC was a more prevalent marker as compared to other tests (11.1%). The prevalence of positive aCL (IgM or IgG) and anti-ß2 GPI (IgM or IgG) was 1.8% (in an elderly woman). Lower oxygen saturation was found in the positive APSRAs group as opposed to the negative APSRAs group (70.3±9 vs. 84.8±9.7%). The mortality rate in the positive APSRAs group was significantly higher relative to the negative APSRAs group (83.3% vs. 27.1%; P-value: 0.01). Likewise, the mechanical ventilation requirement in the positive group was also higher (50% vs. 27.1%, P-value: 0.28).

Conclusion: This study indicated that LAC might be associated with critical cases and high mortality of COVID-19. Nonetheless, the mortality was not related to macrothrombotic incidence.

Citing Articles

Persistent Lupus Anticoagulant Positivity and Long-Term Sequelae Following Mild COVID-19.

Kuniyoshi Y Cureus. 2024; 16(10):e72668.

PMID: 39618655 PMC: 11604992. DOI: 10.7759/cureus.72668.

References
1.
Sevim E, Zisa D, Andrade D, Sciascia S, Pengo V, Tektonidou M . Characteristics of Patients With Antiphospholipid Antibody Positivity in the APS ACTION International Clinical Database and Repository. Arthritis Care Res (Hoboken). 2020; 74(2):324-335. PMC: 10725727. DOI: 10.1002/acr.24468. View

2.
Zhu N, Zhang D, Wang W, Li X, Yang B, Song J . A Novel Coronavirus from Patients with Pneumonia in China, 2019. N Engl J Med. 2020; 382(8):727-733. PMC: 7092803. DOI: 10.1056/NEJMoa2001017. View

3.
Lerma L, Chaudhary A, Bryan A, Morishima C, Wener M, Fink S . Prevalence of autoantibody responses in acute coronavirus disease 2019 (COVID-19). J Transl Autoimmun. 2020; 3:100073. PMC: 7691817. DOI: 10.1016/j.jtauto.2020.100073. View

4.
Tang N, Li D, Wang X, Sun Z . Abnormal coagulation parameters are associated with poor prognosis in patients with novel coronavirus pneumonia. J Thromb Haemost. 2020; 18(4):844-847. PMC: 7166509. DOI: 10.1111/jth.14768. View

5.
Pengo V, Tripodi A, Reber G, Rand J, Ortel T, Galli M . Update of the guidelines for lupus anticoagulant detection. Subcommittee on Lupus Anticoagulant/Antiphospholipid Antibody of the Scientific and Standardisation Committee of the International Society on Thrombosis and Haemostasis. J Thromb Haemost. 2009; 7(10):1737-40. DOI: 10.1111/j.1538-7836.2009.03555.x. View