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pmid32723434      Clin+Exp+Rheumatol 2020 ; 38 (4): 754-759
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  • Frequency and clinical correlates of antiphospholipid antibodies arising in patients with SARS-CoV-2 infection: findings from a multicentre study on 122 cases #MMPMID32723434
  • Gatto M; Perricone C; Tonello M; Bistoni O; Cattelan AM; Bursi R; Cafaro G; De Robertis E; Mencacci A; Bozza S; Vianello A; Iaccarino L; Gerli R; Doria A; Bartoloni E
  • Clin Exp Rheumatol 2020[Jul]; 38 (4): 754-759 PMID32723434show ga
  • OBJECTIVES: COVID-19 features include disseminated intravascular coagulation and thrombotic microangiopathy indicating a hypercoagulable state. We aimed to investigate antiphospholipid antibodies (aPL) prevalence and clinical relationships in a large cohort of COVID-19 patients. METHODS: We analysed the prevalence and titres of serum aPL in 122 patients with COVID-19 and 157 with primary antiphospholipid syndrome (PAPS) and 91 with other autoimmune rheumatic diseases (oARD) for comparison. IgG/IgM anticardiolipin (aCL) and IgG/IgM anti-beta2glycoprotein I (beta2GPI) were assayed using homemade ELISA, IgA aCL and anti-beta2GPI by commercial ELISA kits and lupus anticoagulant (LAC) by multiple coagulation tests following updated international guidelines. RESULTS: Prevalence of IgG and IgM aCL and of IgG and IgM anti-beta2GPI across COVID-19 patients were 13.4%, 2.7%, 6.3% and 7.1%, being significantly lower than in PAPS (p<0.0001 for all). Frequency of IgG aCL and IgM anti-beta2GPI was comparable to oARD (13.4% vs. 13.2% and 7.1% vs. 11%, respectively), while IgG anti-beta2GPI and IgM aCL were lower (p<0.01). IgA aCL and IgA anti-beta2GPI were retrieved in 1.7% and 3.3% of COVID-19 patients, respectively. Positive LAC was observed in 22.2% COVID-19 vs. 54.1% of PAPS (p<0.0001) and 14.6% of oARD (p=0.21). Venous or arterial thromboses occurred in 18/46 (39.1%) COVID-19 patients and were not associated with positive aPL (p=0.09). CONCLUSIONS: Thrombosis is a frequent manifestation during COVID-19 infection. However, prevalence and titres of aPL antibodies or LAC were neither consistently increased nor associated with thrombosis when measured at a single timepoint, therefore not representing a suitable screening tool in the acute stage of disease.
  • |Antibodies, Anticardiolipin/blood[MESH]
  • |Antibodies, Antiphospholipid/*blood[MESH]
  • |Antiphospholipid Syndrome/blood[MESH]
  • |Betacoronavirus[MESH]
  • |COVID-19[MESH]
  • |Coronavirus Infections/blood/*immunology[MESH]
  • |Humans[MESH]
  • |Immunoglobulin G/blood[MESH]
  • |Immunoglobulin M/blood[MESH]
  • |Pandemics[MESH]
  • |Pneumonia, Viral/blood/*immunology[MESH]
  • |SARS-CoV-2[MESH]
  • |Thrombosis/complications/virology[MESH]


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