Evaluation of the Association between Antiphospholipid Antibodies and ICU Admission Outcome in Critically Ill COVID‑19 Patients in Iranian Population

Bahram Pakzad, Marzieh Salehi, Saeed Abbasi, Mohammad Mahdi Salehi, Maryam Kazemi Naeini, Hassan Salehi

Abstract


Background: The role of anti‑phospholipid antibodies (aPLs) in the prognosis of COVID‑19 patients is controversial. In order to prove the role of this factor, the necessary measures such as early initiation of anticoagulants should be started even in the early stages of the disease and in outpatients or the use of other drugs in addition to anticoagulants. We decided to investigate the role of these antibodies in ICU admission outcomes in critically ill COVID‑19 patients.

Methods: The case‑control study was carried out in Isfahan, Iran, from March to September 2021. One hundred nine patients in the case group were selected, including patients admitted to the ICU with a COVID‑19
diagnosis. The 140 patients in the control group were selected from hospitalized and outpatients with COVID‑19 with PCR + and pulmonary involvement, similar to the case group without the need for ICU hospitalization. The anti B2GP1 (IgM, IgG) and anti‑cardiolipin (IgM, IgG)) were compared in two groups.

Results: The frequency percentage of patients in the abnormal group of
anti‑phospholipid antibodies was about 10% in total. No statistically significant difference in these aPLs in continued measures was observed between the two groups of patients admitted to the ICU and those outside the ICU. Also, in the logistics regression analysis, no significant association was observed.

Conclusions: Therefore, the cause of coagulation in patients admitted to the ICU is not related to these aPLs. This means that aPLs could not be a good predictor of patient admission to
the ICU.

Background: The role of anti‑phospholipid antibodies (aPLs) in the prognosis of COVID‑19 patients
is controversial. In order to prove the role of this factor, the necessary measures such as early
initiation of anticoagulants should be started even in the early stages of the disease and in outpatients
or the use of other drugs in addition to anticoagulants. We decided to investigate the role of
these antibodies in ICU admission outcomes in critically ill COVID‑19 patients. Methods: The
case‑control study was carried out in Isfahan, Iran, from March to September 2021. One hundred nine
patients in the case group were selected, including patients admitted to the ICU with a COVID‑19
diagnosis. The 140 patients in the control group were selected from hospitalized and outpatients
with COVID‑19 with PCR + and pulmonary involvement, similar to the case group without the
need for ICU hospitalization. The anti B2GP1 (IgM, IgG) and anti‑cardiolipin (IgM, IgG)) were
compared in two groups. Results: The frequency percentage of patients in the abnormal group of
anti‑phospholipid antibodies was about 10% in total. No statistically significant difference in these
aPLs in continued measures was observed between the two groups of patients admitted to the ICU
and those outside the ICU. Also, in the logistics regression analysis, no significant association was
observed. Conclusions: Therefore, the cause of coagulation in patients admitted to the ICU is not
related to these aPLs. This means that aPLs could not be a good predictor of patient admission to
the ICU.

Keywords


Antiphospholipid antibodies; COVID‑19; ICU admission

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