Outcomes associated with antiphospholipid antibodies in COVID-19 : A prospective cohort study
© 2023 The Authors..
Background: The significance of antiphospholipid antibodies (aPL) in COVID-19 remains uncertain.
Objectives: We determined whether aPL are associated with COVID-19 and/or thrombosis or adverse outcomes during hospitalization for COVID-19.
Methods: Symptomatic adults tested for SARS-CoV-2 for clinical reasons (March-July 2020) with either ≥1 positive polymerase chain reaction (COVID-19+) or all negative (non-COVID-19) results were recruited to a biobank collecting plasma, clinical data, and outcomes. We tested baseline plasma samples (days 0-7) of all subjects (and day-30 samples in the COVID-19+ subjects, when available) for aPL (anticardiolipin immunoglobulin [Ig]M/IgG, anti-β2-glycoprotein I IgM/IgG, antiphosphatidylserine/prothrombin IgM/IgG, and lupus anticoagulant). We compared the baseline prevalence of aPL between the COVID-19+ and non-COVID-19 subjects. Among hospitalized COVID-19+ subjects, multivariable logistic regression was used to evaluate the association of aPL (and their subtypes) with arterial or venous thromboembolic events, acute kidney injury, intensive care unit admission, mechanical ventilation, and death after adjusting for potential confounders.
Results: At baseline, 123 of 289 (43%) COVID+ subjects had ≥1 aPL versus 116 of 261 (32%) non-COVID-19 subjects (difference, 10%; 95% CI, 3%-18%). Among 89 COVID+ subjects with repeated samples, aPL persisted on day 30 in 15 of 34 (44%) subjects with baseline aPL positivity, and half of those without aPL at baseline developed one or more new aPL. In hospitalized COVID-19 subjects (n = 241), baseline aPL positivity was associated with acute kidney injury (odds ratio [OR], 1.8; 95% CI, 1.1-3.2) and mechanical ventilation (OR, 3.2; 95% CI, 1.5-6.8) but not death (OR, 1.2; 95% CI, 0.6-2.5). In secondary analyses, medium-to-high titers of anticardiolipin IgG (>40) were associated with thromboembolic events (OR, 7.3; 95% CI, 1.8-30.1).
Conclusion: In patients with COVID-19, aPL may help identify an increased risk of thrombosis and other adverse outcomes.
| Medienart: |
E-Artikel |
|---|
| Erscheinungsjahr: |
2023 |
|---|---|
| Erschienen: |
2023 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:7 |
|---|---|
| Enthalten in: |
Research and practice in thrombosis and haemostasis - 7(2023), 1 vom: 01. Jan., Seite 100041 |
| Sprache: |
Englisch |
|---|
| Beteiligte Personen: |
Mendel, Arielle [VerfasserIn] |
|---|
| Links: |
|---|
| Themen: |
Acute kidney injury |
|---|
| Anmerkungen: |
Date Revised 09.02.2023 published: Print-Electronic Citation Status PubMed-not-MEDLINE |
|---|
| doi: |
10.1016/j.rpth.2023.100041 |
|---|
| funding: |
|
|---|---|
| Förderinstitution / Projekttitel: |
|
| PPN (Katalog-ID): |
NLM351555455 |
|---|
| LEADER | 01000naa a22002652 4500 | ||
|---|---|---|---|
| 001 | NLM351555455 | ||
| 003 | DE-627 | ||
| 005 | 20231226051644.0 | ||
| 007 | cr uuu---uuuuu | ||
| 008 | 231226s2023 xx |||||o 00| ||eng c | ||
| 024 | 7 | |a 10.1016/j.rpth.2023.100041 |2 doi | |
| 028 | 5 | 2 | |a pubmed24n1171.xml |
| 035 | |a (DE-627)NLM351555455 | ||
| 035 | |a (NLM)36644653 | ||
| 040 | |a DE-627 |b ger |c DE-627 |e rakwb | ||
| 041 | |a eng | ||
| 100 | 1 | |a Mendel, Arielle |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Outcomes associated with antiphospholipid antibodies in COVID-19 |b A prospective cohort study |
| 264 | 1 | |c 2023 | |
| 336 | |a Text |b txt |2 rdacontent | ||
| 337 | |a ƒaComputermedien |b c |2 rdamedia | ||
| 338 | |a ƒa Online-Ressource |b cr |2 rdacarrier | ||
| 500 | |a Date Revised 09.02.2023 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status PubMed-not-MEDLINE | ||
| 520 | |a © 2023 The Authors. | ||
| 520 | |a Background: The significance of antiphospholipid antibodies (aPL) in COVID-19 remains uncertain | ||
| 520 | |a Objectives: We determined whether aPL are associated with COVID-19 and/or thrombosis or adverse outcomes during hospitalization for COVID-19 | ||
| 520 | |a Methods: Symptomatic adults tested for SARS-CoV-2 for clinical reasons (March-July 2020) with either ≥1 positive polymerase chain reaction (COVID-19+) or all negative (non-COVID-19) results were recruited to a biobank collecting plasma, clinical data, and outcomes. We tested baseline plasma samples (days 0-7) of all subjects (and day-30 samples in the COVID-19+ subjects, when available) for aPL (anticardiolipin immunoglobulin [Ig]M/IgG, anti-β2-glycoprotein I IgM/IgG, antiphosphatidylserine/prothrombin IgM/IgG, and lupus anticoagulant). We compared the baseline prevalence of aPL between the COVID-19+ and non-COVID-19 subjects. Among hospitalized COVID-19+ subjects, multivariable logistic regression was used to evaluate the association of aPL (and their subtypes) with arterial or venous thromboembolic events, acute kidney injury, intensive care unit admission, mechanical ventilation, and death after adjusting for potential confounders | ||
| 520 | |a Results: At baseline, 123 of 289 (43%) COVID+ subjects had ≥1 aPL versus 116 of 261 (32%) non-COVID-19 subjects (difference, 10%; 95% CI, 3%-18%). Among 89 COVID+ subjects with repeated samples, aPL persisted on day 30 in 15 of 34 (44%) subjects with baseline aPL positivity, and half of those without aPL at baseline developed one or more new aPL. In hospitalized COVID-19 subjects (n = 241), baseline aPL positivity was associated with acute kidney injury (odds ratio [OR], 1.8; 95% CI, 1.1-3.2) and mechanical ventilation (OR, 3.2; 95% CI, 1.5-6.8) but not death (OR, 1.2; 95% CI, 0.6-2.5). In secondary analyses, medium-to-high titers of anticardiolipin IgG (>40) were associated with thromboembolic events (OR, 7.3; 95% CI, 1.8-30.1) | ||
| 520 | |a Conclusion: In patients with COVID-19, aPL may help identify an increased risk of thrombosis and other adverse outcomes | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a COVID-19 | |
| 650 | 4 | |a SARS-CoV-2 | |
| 650 | 4 | |a acute kidney injury | |
| 650 | 4 | |a adult | |
| 650 | 4 | |a antibodies | |
| 650 | 4 | |a antiphospholipid | |
| 650 | 4 | |a intensive care units | |
| 650 | 4 | |a prospective studies | |
| 650 | 4 | |a thrombosis | |
| 700 | 1 | |a Fritzler, Marvin J |e verfasserin |4 aut | |
| 700 | 1 | |a St-Pierre, Yvan |e verfasserin |4 aut | |
| 700 | 1 | |a Rauch, Joyce |e verfasserin |4 aut | |
| 700 | 1 | |a Bernatsky, Sasha |e verfasserin |4 aut | |
| 700 | 1 | |a Vinet, Évelyne |e verfasserin |4 aut | |
| 773 | 0 | 8 | |i Enthalten in |t Research and practice in thrombosis and haemostasis |d 2017 |g 7(2023), 1 vom: 01. Jan., Seite 100041 |w (DE-627)NLM277257743 |x 2475-0379 |7 nnns |
| 773 | 1 | 8 | |g volume:7 |g year:2023 |g number:1 |g day:01 |g month:01 |g pages:100041 |
| 856 | 4 | 0 | |u http://dx.doi.org/10.1016/j.rpth.2023.100041 |3 Volltext |
| 912 | |a GBV_USEFLAG_A | ||
| 912 | |a GBV_NLM | ||
| 951 | |a AR | ||
| 952 | |d 7 |j 2023 |e 1 |b 01 |c 01 |h 100041 | ||