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Lupus Anticoagulant is Associated With Critical Cases and High Mortality in COVID-19

10 Pages Posted: 5 Jul 2021

See all articles by Maral Moafi

Maral Moafi

Shahid Beheshti University of Medical Sciences - Department of Infectious Diseases and Tropical Medicine

Mohammad Javad Ebrahimi

Shahid Beheshti University of Medical Sciences - Department of Infectious Diseases and Tropical Medicine

Firouze Hatami

Shahid Beheshti University of Medical Sciences - Department of Infectious Diseases and Tropical Medicine

Farid Javandoust Gharehbagh

Shahid Beheshti University of Medical Sciences - Infectious Diseases and Tropical Medicine Research Center

Arman Ahmadzadeh

Shahid Beheshti University of Medical Sciences - Rheumatology Department

Mohammad Mehdi Emam

Shahid Beheshti University of Medical Sciences - Rheumatology Department

Alireza Rajaei

Shahid Beheshti University of Medical Sciences - Rheumatology Department

Ilad Alavi Darazam

Shahid Beheshti University of Medical Sciences - Department of Infectious Diseases and Tropical Medicine

More...

Abstract

Background: In severe COVID-19 cases, hypercoagulable state may occur. Antiphospholipid syndrome related auto-antibodies (APSRAs) contribute to coagulopathy, but their role in COVID-19 remains unclear. We aimed to investigate the prevalence of positive APSRAs and their effect on clinical outcomes in confirmed COVID-19 patients.

Method In this cross-sectional study, severe hospitalized COVID-19 cases were enrolled. Demographic and clinical data were obtained from the day of admission. APSRAs including IgG and/or IgM anticardiolipin (aCL) and anti-β2-glycoprotein1 (anti-β2GP1) as well as lupus anticoagulant (LAC) were measured. 

Finding: In this study, 54 severe COVID-19 cases with positive RT-PCR and/or chest CT scan were recruited. Positive APSRAs was found in 7 (12.9%) patients. Positive LAC was more prevalent marker as compared to other tests (11.1%). The prevalence of positive aCL (IgM or IgG) and anti-ß2 GPI (IgM or IgG) was 1.8% (in an elderly woman). Lower oxygen saturation was found in positive APSRAs group as opposed to negative APSRAs group (70.3±9 vs 84.8±9.7%). Mortality rate in positive APSRAs group was significantly higher relative to negative APSRAs group (83.3% vs 27.1%; P-value: 0.01). Likewise, the mechanical ventilation requirement in the positive group was also higher (50% vs 27.1%, P-value: 0.28). 

Conclusion: This study indicated that LAC directly is associated with critical cases and high mortality of COVID-19. Nonetheless the mortality was not related to macrothrombotic incidence.

Funding Information: There is no funding.

Declaration of Interests: We declare no competing interests.

Ethics Approval Statement: The study was confirmed by the Ethics in Medical Research Committee IR.SBMU.RETECH.REC.1399.1362. Signed informed consents were obtained from all the participants or their legally authorized representatives.

Keywords: COVID-19; SARS-COV-2; antibodies; antiphospholipid; antiphospholipid syndrome; lupus anticoagulant; thrombosis

Suggested Citation

Moafi, Maral and Ebrahimi, Mohammad Javad and Hatami, Firouze and Javandoust Gharehbagh, Farid and Ahmadzadeh, Arman and Emam, Mohammad Mehdi and Rajaei, Alireza and Alavi Darazam, Ilad, Lupus Anticoagulant is Associated With Critical Cases and High Mortality in COVID-19. Available at SSRN: https://ssrn.com/abstract=3880443 or http://dx.doi.org/10.2139/ssrn.3880443

Maral Moafi

Shahid Beheshti University of Medical Sciences - Department of Infectious Diseases and Tropical Medicine ( email )

Tehran
Iran

Mohammad Javad Ebrahimi

Shahid Beheshti University of Medical Sciences - Department of Infectious Diseases and Tropical Medicine ( email )

Tehran
Iran

Firouze Hatami

Shahid Beheshti University of Medical Sciences - Department of Infectious Diseases and Tropical Medicine ( email )

Tehran
Iran

Farid Javandoust Gharehbagh

Shahid Beheshti University of Medical Sciences - Infectious Diseases and Tropical Medicine Research Center ( email )

Velenjak Street, Shahid Chamran High Way
Tehran
Iran

Arman Ahmadzadeh

Shahid Beheshti University of Medical Sciences - Rheumatology Department ( email )

Velenjak Street, Shahid Chamran High Way
Tehran
Iran

Mohammad Mehdi Emam

Shahid Beheshti University of Medical Sciences - Rheumatology Department ( email )

Velenjak Street, Shahid Chamran High Way
Tehran
Iran

Alireza Rajaei

Shahid Beheshti University of Medical Sciences - Rheumatology Department ( email )

Velenjak Street, Shahid Chamran High Way
Tehran
Iran

Ilad Alavi Darazam (Contact Author)

Shahid Beheshti University of Medical Sciences - Department of Infectious Diseases and Tropical Medicine ( email )

Tehran
Iran