Changes in the Level of Antiphospholipid Antibodies (Anticardiolipin and Anti‑β2‑Glycoprotein‑I) and Thromboembolic Indices in COVID‑19 Patients during 3 Weeks

Somayeh Haghighipour, Mansour Salesi, Fereshteh Keikhaei, Mohammad J. Tarrahi, Zahra Khani, Hassan Salehi

Abstract


Introduction: COVID‑19 is a respiratory disease caused by infection with severe acute respiratory syndrome Coronavirus 2 (SARS‑CoV‑2). Thrombotic complications appear to be of particular importance in patients with COVID‑19. This study aimed to investigate Changes in the level of Antiphospholipid antibodies (Anticardiolipin and Anti‑β2‑glycoprotein‑I) and thromboembolic indices in COVID‑19 patients during 3 weeks. Methods: This cross‑sectional study was performed on adults with Covid‑19 hospitalized at Al‑Zahra Hospital in Isfahan. The case group includes the patients admitted to the internal ward or ICU who despite receiving prophylactic or anticoagulant doses suffer from thrombotic complications and the control group includes COVID‑19 patients without thromboembolic events. The sample size of 120 people was considered. Anticardiolipin and anti‑β2‑glycoprotein‑I antibodies, coagulation profiles including Fibrinogen, PTT, PT Troponin, ESR, CRP, and D‑dimer were examined. After collection, the data were entered into spss24 software and analyzed. Results: The results showed that there was no statistically significant difference in the changes of anticardiolipin and anti‑beta‑2 glycoprotein in IgM and IgG as well as in the changes of ESR, CRP, PTT, PT, and fibrinogen in the two groups (P > 0.05). Conclusions: Our study showed that there was no statistically significant relationship between anti‑phospholipid antibodies (anticardiolipin and anti‑beta‑2 glycoprotein) and thromboembolic events. Therefore anticardiolipin and anti‑beta‑2 glycoprotein is probably the puzzles causing thrombosis in COVID‑19 patients, and other inflammatory responses should be examined among the cases.

Keywords


Anticardiolipin; anti‑β2‑glycoprotein‑I; COVID‑19; thrombosis

Full Text:

PDF

References


Wang D, Hu B, Hu C, Zhu F, Liu X, Zhang J, et al. Clinical

characteristics of 138 hospitalized patients with 2019 novel

coronavirus–infected pneumonia in Wuhan, China. JAMA

;323:1061‑9.

Zhu H, Wei L, Niu P. The novel coronavirus outbreak in Wuhan,

China. Global Health Res Policy 2020;5:1‑3. doi: 10.1186/

s41256‑020‑00135‑6.

Guan W‑J, Ni Z‑Y, Hu Y, Liang W‑H, Ou C‑Q, He J‑X, et al.

Clinical characteristics of coronavirus disease 2019 in China.

N Engl J Med 2020;382:1708‑20.

Huang C, Wang Y, Li X, Ren L, Zhao J, Hu Y, et al. Clinical

features of patients infected with 2019 novel coronavirus in

Wuhan, China. Lancet 2020;395:497‑506.

Han S, Mallampalli RK. The acute respiratory distress syndrome:

From mechanism to translation. J Immunol 2015;194:855‑60.

Bikdeli B, Madhavan MV, Jimenez D, Chuich T, Dreyfus I,

Driggin E, et al. COVID‑19 and thrombotic or thromboembolic

disease: Implications for prevention, antithrombotic therapy,

and follow‑up: JACC state‑of‑the‑art review. J Am Coll Cardiol

;75:2950‑73.

Driggin E, Madhavan MV, Bikdeli B, Chuich T, Laracy J,

Biondi‑Zoccai G, et al. Cardiovascular considerations for

patients, health care workers, and health systems during the

COVID‑19 pandemic. J Am Coll Cardiol 2020;75:2352‑71.

Tang Y‑W, Schmitz JE, Persing DH, Stratton CW. Laboratory

diagnosis of COVID‑19: Current issues and challenges. J Clin

Microbiol 2020;58:e00512‑20. doi: 10.1128/JCM.00512‑20.

Cui S, Chen S, Li X, Liu S, Wang F. Prevalence of venous

thromboembolism in patients with severe novel coronavirus

pneumonia. J Thromb Haemost 2020;18:1421‑4.

Klok FA, Kruip MJHA, Van Der Meer NJ, Arbous MS,

Gommers DA, et al. Confirmation of the high cumulative

incidence of thrombotic complications in critically ill ICU

patients with COVID‑19: An updated analysis. Thromb Res

;191:148‑50.

Helms J, Tacquard C, Severac F, Leonard‑Lorant I, Ohana M,

Delabranche X, et al. High risk of thrombosis in patients with

severe SARS‑CoV‑2 infection: A multicenter prospective cohort

study. Intensive Care Med 2020;46:1089‑98.

Poissy J, Goutay J, Caplan M, Parmentier E, Duburcq T,

Lassalle F, et al. Pulmonary embolism in patients with

COVID‑19: Awareness of an increased prevalence. Circulation

;142:184‑6.

Iba T, Levy JH, Connors JM, Warkentin TE, Thachil J, Levi M.

The unique characteristics of COVID‑19 coagulopathy. Crit Care

;24:1‑8. doi: 10.1186/s13054‑020‑03077‑0.

Zhang Y, Xiao M, Zhang S, Xia P, Cao W, Jiang W, et al.

Coagulopathy and antiphospholipid antibodies in patients with

Covid‑19. N Engl J Med 2020;382:e38.

Harzallah I, Debliquis A, Drénou B. Lupus anticoagulant is

frequent in patients with Covid‐19: Response to reply. J Thromb

Haemost 2020;18:E3‑4.

Garcia D, Erkan D. Diagnosis and management of the

antiphospholipid syndrome. N Engl J Med 2018;378:2010‑21.

Najim M, Rahhal A, Khir F, Aljundi AH, Yousef SA, Ibrahim F,

et al. Prevalence and clinical significance of antiphospholipid

antibodies in patients with coronavirus disease 2019 admitted

to intensive care units: A prospective observational study.

Rheumatol Int 2021;41:1243‑52.

Borghi MO, Beltagy A, Garrafa E, Curreli D, Cecchini G,

Bodio C, et al. Anti‑phospholipid antibodies in COVID‑19

are different from those detectable in the anti‑phospholipid

syndrome. Front Immunol 2020;11:2692.

Frapard T, Hue S, Rial C, de Prost N, Mekontso Dessap A.

Antiphospholipid Autoantibodies and Thrombosis in Patients

With COVID‐19: Comment on the Article by Bertin et al.

Arthritis & Rheumatology. 2021;73:897-9.

Galeano‑Valle F, Oblitas C, Ferreiro‑Mazón M,

Alonso‑Muñoz J, Del Toro‑Cervera J, Di Natale M, et al.

Antiphospholipid antibodies are not elevated in patients with

severe COVID‑19 pneumonia and venous thromboembolism.

Thromb Res 2020;192:113‑5.

Le Joncour A, Frere C, Martin‑Toutain I, Gougis P,

Ghillani‑Dalbin P, Maalouf G, et al. Antiphospholipid antibodies

and thrombotic events in COVID‑19 patients hospitalized in

medicine ward. Autoimmun Rev 2021;20:102729. doi: 10.1016/j.

autrev. 2020.102729.

Pavoni V, Gianesello L, Horton A. Antiphospholipid antibodies

in critically ill COVID‑19 patients with thromboembolism:

Cause of disease or epiphenomenon? J Thromb Thrombolysis

;52:542‑52.

Leonard‑Lorant I, Delabranche X, Severac F, Helms J, Pauzet C,

Collange O. Acute pulmonary embolism in COVID‑19 patients

on CT angiography and relationship to D‑Dimer levels.

Radiology 2020;296:E189‑91. doi: 10.1148/radiol.2020201561.