Antiphospholipid Antibodies Occurrence in Acute SARS-CoV-2 Infection without Overt Thrombosis

Abstract

We sought to determine the prevalence of antiphospholipid antibodies (aPLs) and their correlation with COVID-19 severity (in terms of clinical and laboratory parameters) in patients without thrombotic events during the early phase of infection. This was a cross-sectional study with the inclusion of hospitalized COVID-19 patients from a single department during the COVID-19 pandemic (April 2020–May 2021). Previous known immune disease or thrombophilia along with long-term anticoagulation and patients with overt arterial or venous thrombosis during SARS-CoV-2 infection were excluded. In all cases, data on four criteria for aPL were collected, namely lupus anticoagulant (LA), IgM and IgG anticardiolipin antibodies (aCL), as well as IgG anti-β2 glycoprotein I antibodies (aβ2GPI). One hundred and seventy-nine COVID-19 patients were included, with a mean age of 59.6 (14.5) years and a sex ratio of 0.8 male: female. LA was positive in 41.9%, while it was strongly positive in 4.5%; aCL IgM was found in 9.5%, aCL IgG in 4.5%, and aβ2GPI IgG in 1.7% of the sera tested. Clinical correlation: LA was more frequently expressed in severe COVID-19 cases than in moderate or mild cases (p = 0.027). Laboratory correlation: In univariate analysis, LA levels were correlated with D-dimer (p = 0.016), aPTT (p = 0.001), ferritin (p = 0.012), C-reactive protein (CRP) (p = 0.027), lymphocyte (p = 0.040), and platelet (p < 0.001) counts. However, in the multivariate analysis, only the CRP levels correlated with LA positivity: OR (95% CI) 1.008 (1.001–1.016), p = 0.042. LA was the most common aPL identified in the acute phase of COVID-19 and was correlated with infection severity in patients without overt thrombosis.

COVID-19 and Laboratory Markers from Romanian Patients—A Narrative Review

“…Another such correlation was observed by Cerbu et al in their study regarding patients with hepatitis, where, due to the liver impairment caused by the underlying condition, statistically significant differences were observed between patients with hepatitis and those without (56 mg/L vs. 12 mg/L) [ 44 ]. Other conditions correlated with CRP levels in SARS-CoV-2 infection are heart conditions according to Pilut et al and Tudoran et al [ 33 , 45 , 46 ], thromboembolic events due to lupus antibodies, as observed in a multivariate analysis by Dima et al (OR = 1.008, 95% CI: 1.001–1.016) [ 47 ], and type 2 diabetes according to Restea et al and Gradisteanu et al [ 48 , 49 ]. Another study from 2022 investigated a link between laboratory markers and features found on the Computer Tomography (CT) results.…”

“…The major laboratory markers that were studied by Romanian authors are displayed in Table 1. Yes, even more so in Roma [53,54,[58][59][60][61][62]70] Diabetes [48,94] Antiphospholipid syndrome [47] Hypertension [27] Cardiac dysfunction [46,73,93] Overweight/metabolic syndrome [27,54,93] Lung involvement [50,57] PIMS [83] Chronic Spontaneous Urticaria Exacerbation [42] Pneumothorax/ pneumomediastinum [31,72] Liver failure [44] Multiple organ dysfunction [ [57,58,102,103] No [55] More comorbidities [29,101] Lung involvement [57] In addition, this article aimed to identify gaps in this research and provide encouragement for Romanian research to focus on novel and detailed aspects of the pandemic. For instance, as Romania grapples with the aftermath of the COVID-19 pandemic, understanding the long-term effects of the disease is of paramount importance.…”