tetano
Editor, Senior Moderator
Rheumatol Int
. 2021 May 5.
doi: 10.1007/s00296-021-04875-7. Online ahead of print.
Prevalence and clinical significance of antiphospholipid antibodies in patients with coronavirus disease 2019 admitted to intensive care units: a prospective observational study
Mostafa Najim[SUP] #[/SUP][SUP] 1 [/SUP], Alaa Rahhal[SUP] #[/SUP][SUP] 2 [/SUP], Fadi Khir[SUP] 3 [/SUP], Amer Hussien Aljundi[SUP] 2 [/SUP], Safae Abu Yousef[SUP] 2 [/SUP], Feryal Ibrahim[SUP] 4 [/SUP], Aliaa Amer[SUP] 4 [/SUP], Ahmed S Mohamed[SUP] 5 [/SUP], Samira Saleh[SUP] 4 [/SUP], Dekra Alfaridi[SUP] 4 [/SUP], Ahmed Mahfouz[SUP] 2 [/SUP], Sumaya Alyafei[SUP] 2 [/SUP], Faraj Howady[SUP] 6 [/SUP], Mohamad Khatib[SUP] 7 [/SUP], Samar A Alemadi[SUP] 8 [/SUP]
Affiliations
Abstract
Coronavirus disease 2019 (COVID-19) increases the risk of coagulopathy. Although the presence of antiphospholipid antibodies (aPLs) has been proposed as a possible mechanism of COVID-19-induced coagulopathy, its clinical significance remains uncertain. Therefore, this study aimed to evaluate the prevalence and clinical significance of aPLs among critically ill patients with COVID-19. This prospective observational study included 60 patients with COVID-19 admitted to intensive care units (ICU). The study outcomes included prevalence of aPLs, and a primary composite outcome of all-cause mortality and arterial or venous thrombosis between antiphospholipid-positive and antiphospholipid-negative patients during their ICU stay. Multiple logistic regression was used to assess the influence of aPLs on the primary composite outcome of mortality and thrombosis. A total of 60 critically ill patients were enrolled. Among them, 57 (95%) were men, with a mean age of 52.8 ? 12.2 years, and the majority were from Asia (68%). Twenty-two patients (37%) were found be antiphospholipid-positive; 21 of them were positive for lupus anticoagulant, whereas one patient was positive for anti-?2-glycoprotein IgG/IgM. The composite outcome of mortality and thrombosis during their ICU stay did not differ between antiphospholipid-positive and antiphospholipid-negative patients (4 [18%] vs. 6 [16%], adjusted odds ratio 0.98, 95% confidence interval 0.1-6.7; p value = 0.986). The presence of aPLs does not seem to affect the outcomes of critically ill patients with COVID-19 in terms of all-cause mortality and thrombosis. Therefore, clinicians may not screen critically ill patients with COVID-19 for aPLs unless deemed clinically appropriate.
Keywords: Antiphospholipid antibodies; Arterial thrombosis; COVID-19; Coagulopathy; Critically ill patients; Venous thrombosis.
. 2021 May 5.
doi: 10.1007/s00296-021-04875-7. Online ahead of print.
Prevalence and clinical significance of antiphospholipid antibodies in patients with coronavirus disease 2019 admitted to intensive care units: a prospective observational study
Mostafa Najim[SUP] #[/SUP][SUP] 1 [/SUP], Alaa Rahhal[SUP] #[/SUP][SUP] 2 [/SUP], Fadi Khir[SUP] 3 [/SUP], Amer Hussien Aljundi[SUP] 2 [/SUP], Safae Abu Yousef[SUP] 2 [/SUP], Feryal Ibrahim[SUP] 4 [/SUP], Aliaa Amer[SUP] 4 [/SUP], Ahmed S Mohamed[SUP] 5 [/SUP], Samira Saleh[SUP] 4 [/SUP], Dekra Alfaridi[SUP] 4 [/SUP], Ahmed Mahfouz[SUP] 2 [/SUP], Sumaya Alyafei[SUP] 2 [/SUP], Faraj Howady[SUP] 6 [/SUP], Mohamad Khatib[SUP] 7 [/SUP], Samar A Alemadi[SUP] 8 [/SUP]
Affiliations
- PMID: 33954813
- DOI: 10.1007/s00296-021-04875-7
Abstract
Coronavirus disease 2019 (COVID-19) increases the risk of coagulopathy. Although the presence of antiphospholipid antibodies (aPLs) has been proposed as a possible mechanism of COVID-19-induced coagulopathy, its clinical significance remains uncertain. Therefore, this study aimed to evaluate the prevalence and clinical significance of aPLs among critically ill patients with COVID-19. This prospective observational study included 60 patients with COVID-19 admitted to intensive care units (ICU). The study outcomes included prevalence of aPLs, and a primary composite outcome of all-cause mortality and arterial or venous thrombosis between antiphospholipid-positive and antiphospholipid-negative patients during their ICU stay. Multiple logistic regression was used to assess the influence of aPLs on the primary composite outcome of mortality and thrombosis. A total of 60 critically ill patients were enrolled. Among them, 57 (95%) were men, with a mean age of 52.8 ? 12.2 years, and the majority were from Asia (68%). Twenty-two patients (37%) were found be antiphospholipid-positive; 21 of them were positive for lupus anticoagulant, whereas one patient was positive for anti-?2-glycoprotein IgG/IgM. The composite outcome of mortality and thrombosis during their ICU stay did not differ between antiphospholipid-positive and antiphospholipid-negative patients (4 [18%] vs. 6 [16%], adjusted odds ratio 0.98, 95% confidence interval 0.1-6.7; p value = 0.986). The presence of aPLs does not seem to affect the outcomes of critically ill patients with COVID-19 in terms of all-cause mortality and thrombosis. Therefore, clinicians may not screen critically ill patients with COVID-19 for aPLs unless deemed clinically appropriate.
Keywords: Antiphospholipid antibodies; Arterial thrombosis; COVID-19; Coagulopathy; Critically ill patients; Venous thrombosis.