Anti-phospholipid autoantibodies in COVID-19 patients

Jordhani, M.; Ruci, D.; Ruci, V.

Background: Because of the inflammation boosting cytokines, Coronavirus disease 2019 (COVID-19) has demonstrated thrombotic consequences that have increased its morbidity and mortality. There is evidence that mechanisms that contribute in thrombosis in COVID-19 patients are similar to those in anti-phospholipid syndrome (aPS). In fact, there is a possibility that anti-phospholipid autoantibodies (aPLs) might impulse thrombosis in patients with COVID-19, as literature suggests2. Objectives: The aim of our study was to evaluate the anti-phospholipid autoantibody titre in patients with COVID-19 during and after the infection. Methods: This is an observational study which included 71 patients with a recent COVID-19 up to 4 weeks after. Every patient was completed with aPL titre about IgG and IgM anti-cardiolipine (ACA) and lupus anticoagulant (LAC) autoantibodies. According to titre results, the patients were divided into groups in order to better show the immunologic results. Results: After gathering and analysing the data, it was estimated that 21 patients (29.6%) were positive for at least one type of aPL antibody: 12 patients were found positive for lupus anticoagulant autoantibodies (57.1%), 6 patients were double positive for LAC and ACA (28.6%), and 3 patients were positive for anti-cardiolipin antibodies (14.3%). Seven patients were IgM positive for any aPL (33.3%), 6 patients were found to have positive IgM and IgG (28.6%) and 8 patients had only IgG antibodies (38.1%). Conclusion: From this study it was observed that a significant proportion of patients with recent COVID-19 infection had positive anti-phospholipid antibodies, compared to the general population prevalence. This suggests that the impact of aPLs in COVID-19 might be of great importance. It should be carefully evaluated in order to better understand the mechanisms of thrombotic complications.