Assessment of antiphospholipid antibodies profiles based on severity of COVID-19 pneumonia

Pan Afr Med J. 2022 Jun 9;42:110. doi: 10.11604/pamj.2022.42.110.33020. eCollection 2022.

Abstract

Introduction: thrombotic events are the most severe complications of the coronavirus disease 2019 (COVID-19). It is known that anti-phospholipid antibodies (APL) could be involved in thrombosis mechanism. Thus, APL profiles were studied particularly in patients with severe and critical COVID-19, and their clinical impact.

Methods: a retrospective study of 54 COVID-19 hospitalized patients (34 in intensive care unit (ICU) and 20 in non-ICU) was conducted. These COVID-19 patients were tested for the presence of LAC (lupus anticoagulant) using the ACLTOP750®, anti-cardiolipine (ACL) and anti-β2glycoprotéine I (anti-β2GPI) IgG/IgM/IgA by enzyme-linked immunosorbent assay (ELISA). IgA isotype was tested in only 25 patients.

Results: anti-phospholipid antibodies were present in 74.1% of tested patients. LAC positivity was the highest (60.8%) among all patients, followed by IgM aCL (18.5%) and IgM anti-β2GPI (14.8%). Besides, LAC and anti-β2GPI IgA were the most predominant APL regarding the 25 patients tested for IgA isotype (52% and 24% respectively). Nine patients had thrombotic events, among them 6 were positive in APL and 5 were positive in LAC. However, there was any significant association between APL positivity or titers and thrombosis. There was also no significant difference between the two COVID-19 groups regarding APL profiles.

Conclusion: given the relatively high frequency of APL and especially LAC, and given the multitude of thrombotic risk factors in these severely and critically ill COVID-19 patients, a prophylactic anticoagulation remains essential.

Keywords: Antibodies; COVID-19; antiphospholipid; lupus anticoagulant; thrombosis.

MeSH terms

  • Antibodies, Anticardiolipin
  • Antibodies, Antiphospholipid
  • Antiphospholipid Syndrome*
  • COVID-19*
  • Humans
  • Immunoglobulin A
  • Immunoglobulin M
  • Retrospective Studies
  • Thrombosis*
  • beta 2-Glycoprotein I

Substances

  • Antibodies, Anticardiolipin
  • Antibodies, Antiphospholipid
  • Immunoglobulin A
  • Immunoglobulin M
  • beta 2-Glycoprotein I