Prevalence and clinical significance of antiphospholipid antibodies among hospitalized COVID-19 patients

Cesarius Singgih Wahono; Tri Wahyudi Iman Dantara; Perdana Aditya Rahman; Mirza Zaka Pratama; Hani Susianti; Indah Adhita Wulanda; Khoirunisah Dwi Hartanti; Kusworini Handono; Elvira Sari Dewi

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Prevalence and clinical significance of antiphospholipid antibodies among hospitalized COVID-19 patients

Author: Cesarius Singgih WAHONO ¹ ; Tri Wahyudi Iman DANTARA ¹ ; Perdana Aditya RAHMAN ¹ ; Mirza Zaka PRATAMA ¹ ; Hani SUSIANTI ² ; Indah Adhita WULANDA ² ; Khoirunisah Dwi HARTANTI ² ; Kusworini HANDONO ² ; Elvira Sari DEWI ³
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1. Rheumatology and Immunology Division, Department of Internal Medicine, Faculty of Medicine, University of Brawijaya
2. Department of Clinical Pathology, Faculty of Medicine, University of Brawijaya
3. Basic Nursing Department, Faculty of Medicine, University of Brawijaya
Publication Type:Journal Article
Keywords: Antiphospholipid antibodies; COVID-19; COVID-19 disease severity; Mortality
From: Asian Pacific Journal of Tropical Medicine 2021;14(8):350-355
CountryChina
Language:Chinese
Abstract: Objective: To describe the prevalence of antiphospholipid antibodies in coronavirus disease-19 (COVID-19) and to find potential associations between antiphospholipid antibody positivity and clinical outcomes. Methods: From September to November 2020, clinical and laboratory data were collected from 50 COVID-19 patients hospitalized at Saiful Anwar General Hospital in Malang, Indonesia. Antiphospholipid antibodies were measured by finding IgM anti-β2 glycoprotein, lupus anticoagulant, and IgM/IgG anticardiolipin. Clinical characteristics, thrombotic events, ICU admission, and mortality during hospitalization were recorded. Disease severity was defined by the Guidelines for the Prevention and Control of COVID-19, Indonesia. Results: Among 50 patients, 5 patients (10.0%) were positive for antiphospholipid antibodies: 4 patients (80.0%) had IgM anti-β2 glycoprotein and 1 patient had IgG anti-cardiolipin (20.0%) and IgM anti-cardiolipin (20.0%), none of lupus anticoagulant was detected. Antiphospholipid antibodies were associated with anosmia (OR 8.1; 95% CI 1.1-57.9; P=0.018), nausea and vomiting (OR 12.4; 95% CI 1.2-122.6; P=0.010), diarrhea (OR 9.8; 95% CI 1.3-70.9; P=0.010), cardiovascular disease (OR 1.4; 95% CI 1.0-1.9; P=0.001), chronic kidney disease (OR 12.0; 95% CI 1.6-90.1; P=0.05), acute coronary syndrome (OR 29.3; 95% CI 2.0-423.7; P=0.001), moderate (OR 0.11; 95% CI 0.01-1.10; P=0.031) and severe (OR 18.5; 95% CI 1.8-188.4; P=0.002) disease severity, and in-hospital mortality (OR 8.1; 95% CI 1.1-57.9; P=0.018). However, there is no correlation between the presence of antiphospholipid antibody and ICU admission. Conclusions: In summary, the prevalence of antiphospholipid antibodies in COVID-19 patients is low, mainly against IgM anticardiolipin, and is associated with an acute coronary syndrome, gastrointestinal manifestations, moderate and severe disease severity, and increased risk of mortality.