Systematic Review of Antiphospholipid Antibodies in COVID-19 Patients: Culprits or Bystanders?

Foret, Thomas; Dufrost, Virginie; du Mont, Lucie Salomon; Costa, Patricia; Lefevre, Benjamin; Lacolley, Patrick; Regnault, Veronique; Zuily, Stephane; Wahl, Denis

PURPOSE OF REVIEW: COVID-19 patients have a procoagulant state with a high prevalence of thrombotic events. The hypothesis of an involvement of antiphospholipid antibodies (aPL) has been suggested by several reports. Here, we reviewed 48 studies investigating aPL in COVID-19 patients. RECENT FINDINGS: Prevalence of Lupus Anticoagulant (LA) ranged from 35% to 92% in ICU patients. Anti-cardiolipin (aCL) IgG and IgM were found in up to 52% and up to 40% of patients respectively. Anti-β(2)-glycoprotein I (aβ(2)-GPI) IgG and IgM were found in up to 39% and up to 34% of patients respectively. Between 1% and 12% of patients had a triple positive aPL profile. There was a high prevalence of aβ(2)-GPI and aCL IgA isotype. Two cohort studies found few persistent LA but more persistent solid phase assay aPL over time. SUMMARY: aPL determination and their potential role is a real challenge for the treatment of this disease.