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Anti-Phospholipid Antibodies in COVID-19 Are Different From Those Detectable in the Anti-Phospholipid Syndrome

BACKGROUND: Critically ill patients with coronavirus disease 2019 (COVID-19) have a profound hypercoagulable state and often develop coagulopathy which leads to organ failure and death. Because of a prolonged activated partial-thromboplastin time (aPTT), a relationship with anti-phospholipid antibod...

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Detalles Bibliográficos
Autores principales: Borghi, Maria Orietta, Beltagy, Asmaa, Garrafa, Emirena, Curreli, Daniele, Cecchini, Germana, Bodio, Caterina, Grossi, Claudia, Blengino, Simonetta, Tincani, Angela, Franceschini, Franco, Andreoli, Laura, Lazzaroni, Maria Grazia, Piantoni, Silvia, Masneri, Stefania, Crisafulli, Francesca, Brugnoni, Duilio, Muiesan, Maria Lorenza, Salvetti, Massimo, Parati, Gianfranco, Torresani, Erminio, Mahler, Michael, Heilbron, Francesca, Pregnolato, Francesca, Pengo, Martino, Tedesco, Francesco, Pozzi, Nicola, Meroni, Pier Luigi
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7593765/
https://www.ncbi.nlm.nih.gov/pubmed/33178218
http://dx.doi.org/10.3389/fimmu.2020.584241
Descripción
Sumario:BACKGROUND: Critically ill patients with coronavirus disease 2019 (COVID-19) have a profound hypercoagulable state and often develop coagulopathy which leads to organ failure and death. Because of a prolonged activated partial-thromboplastin time (aPTT), a relationship with anti-phospholipid antibodies (aPLs) has been proposed, but results are controversial. Functional assays for aPL (i.e., lupus anticoagulant) can be influenced by concomitant anticoagulation and/or high levels of C reactive protein. The presence of anti-cardiolipin (aCL), anti-beta2-glycoprotein I (anti-β(2)GPI), and anti-phosphatidylserine/prothrombin (aPS/PT) antibodies was not investigated systematically. Epitope specificity of anti-β(2)GPI antibodies was not reported. OBJECTIVE: To evaluate the prevalence and the clinical association of aPL in a large cohort of COVID-19 patients, and to characterize the epitope specificity of anti-β(2)GPI antibodies. METHODS: ELISA and chemiluminescence assays were used to test 122 sera of patients suffering from severe COVID-19. Of them, 16 displayed major thrombotic events. RESULTS: Anti-β(2)GPI IgG/IgA/IgM was the most frequent in 15.6/6.6/9.0% of patients, while aCL IgG/IgM was detected in 5.7/6.6% by ELISA. Comparable values were found by chemiluminescence. aPS/PT IgG/IgM were detectable in 2.5 and 9.8% by ELISA. No association between thrombosis and aPL was found. Reactivity against domain 1 and 4-5 of β(2)GPI was limited to 3/58 (5.2%) tested sera for each domain and did not correlate with aCL/anti-β(2)GPI nor with thrombosis. CONCLUSIONS: aPL show a low prevalence in COVID-19 patients and are not associated with major thrombotic events. aPL in COVID-19 patients are mainly directed against β(2)GPI but display an epitope specificity different from antibodies in antiphospholipid syndrome.