Anti-Phospholipid Antibodies in COVID-19 Are Different From Those Detectable in the Anti-Phospholipid Syndrome

Borghi, María Orietta; Beltagy, Asmaa; Garrafa, Emirena; Curreli, Daniele; Cecchini, Germana; Bodio, Caterina; Grossi, Claudia; Blengino, Simonetta; Tincani, Anǵela; Franceschini, Franco; Andréoli, Laura; Lazzaroni, Maria Grazia; Piantoni, Silvia; Masneri, Stefania; Crisafulli, Francesca; Brugnoni, Duilio; Muiesan, María Lorenza; Salvetti, Massimo; Parati, Gianfranco; Torresani, Erminio; Mähler, Michael; Heilbron, Francesca; Pregnolato, Francesca; Pengo, Martino; Tedesco, Francesco; Pozzi, Nicola; Meroni, Pier Luigi

doi:10.3389/fimmu.2020.584241

Cited by 147 publications

(153 citation statements)

References 37 publications

(60 reference statements)

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“…IgG anticardiolipin and anti-β2glycoprotein-I antibodies were also prevalent, but often in low titers. Notably, one study revealed 3 (5%) of 58 COVID-19 patients had a highly thrombogenic anti-β2glycoprotein-I domain I IgG antibody, although not correlated with thrombosis (41). The strong association of aPL with thrombotic events was not observed in most studies, even for patients with double/triple positivity.…”

Section: Antiphospholipid Antibody Syndrome (Aps)mentioning

confidence: 97%

“…As demonstrated in Table 2, the presence of antiphospholipid antibodies (aPL) has been observed in COVID-19 patients around the world (18)(19)(20)(39)(40)(41)(42)(43)(44)(45)(46)(47)(48)(49)(50)(51)(52)(53)(54)(55). The association between aPL and disease severity was shown in three studies (39,54,56), but not in another study (46).…”

Section: Antiphospholipid Antibody Syndrome (Aps)mentioning

confidence: 98%

See 1 more Smart Citation

Autoimmune and Rheumatic Manifestations Associated With COVID-19 in Adults: An Updated Systematic Review

2021

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Background: Numerous cases of the coronavirus disease 2019 (COVID-19) with autoimmune and rheumatic manifestations have been reported. Despite the available reviews that summarized its autoimmune/rheumatic manifestations, a systematic approach is still lacking. Therefore, we conducted a comprehensive systematic review in order to give an overview upon these rare but clinically significant manifestations.Methods: We performed a literature search of PubMed and EMBASE as of October 9, 2020. All articles relevant to either systemic or organ-specific autoimmune and rheumatic manifestations potentially associated with COVID-19 were collected. The reviewed literature were limited to adults ≥18 years.Results: Although most of the existing evidence was based on case reports or case series without a long-term follow-up, a variety of autoimmune/rheumatic manifestations were associated with COVID-19. The manifestations that have a consistent association with COVID-19 include autoimmune cytopenia, cutaneous vasculitis, encephalitis, and Guillain-Barre syndrome. Such association is conflicting as regards to antiphospholipid syndrome, hemophagocytic lymphohistiocytosis, and myasthenia gravis.Conclusion: Our systematic review indicated the potential of the COVID-19 virus to trigger a myriad of autoimmune and rheumatic manifestations, which should be considered amid global efforts to combat COVID-19.

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Section: Antiphospholipid Antibody Syndrome (Aps)mentioning

confidence: 97%

Section: Antiphospholipid Antibody Syndrome (Aps)mentioning

confidence: 98%

Autoimmune and Rheumatic Manifestations Associated With COVID-19 in Adults: An Updated Systematic Review

2021

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“…Using APLA assays similar to ours, Borghi, et al . reported a low prevalence of APLA in COVID + sera, where the most common target was IgG β2-GP1 (15.6%) 17 . In addition, the primary β2GP1 antibody targets were in domains 2-4 which are less specific for APS 17 .…”

Section: Discussionmentioning

confidence: 98%

“…The pathological significance of aCL seropositivity is unclear since there were no major differences in platelet counts or thrombotic events in the two cohorts. Others have reported a high prevalence of aCL autoantibodies among COVID + patients, but these studies lacked contemporaneous COVID - control groups of similar disease severity 5 6 16 17 .…”

Section: Discussionmentioning

confidence: 99%

Anti-cardiolipin and other anti-phospholipid antibodies in critically ill COVID-19 positive and negative patients

Trahtemberg

Rottapel

DosSantos

et al. 2021

Preprint

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Background: Reports of severe COVID-19 being associated with thrombosis, anti-phospholipid antibodies (APLA), anti-phospholipid syndrome (APS) have yielded disparate conclusions. Studies comparing COVID-19 patients with contemporaneous controls of similar severity are lacking. Methods: 22 COVID+ and 20 COVID- patients with respiratory failure admitted to intensive care were studied longitudinally. Demographic and clinical data were obtained from the day of admission. APLA testing included anti-cardiolipin (aCL), anti-β2glycoprotein 1 (β2GP1), anti-domain 1 β2 glycoprotein 1 (β2GP1) and anti-phosphatidyl serine/prothrombin complex (PS/PT). Anti-nuclear antibodies (ANA) were detected by immunofluorescence and antibodies to cytokines by a commercially available multiplexed array. ANOVA was used for continuous variables and Fisher exact test was used for categorical variables with α=0.05 and the false discovery rate at q=0.05. Results: APLA were predominantly IgG aCL (48%) followed by IgM (21%) in all patients, with a tendency toward higher frequency among the COVID+. aCL was not associated with surrogate markers of thrombosis but IgG aCL was strongly associated with worse disease severity and higher ANA titers regardless of COVID-19 status. An association between aCL and anti-cytokine autoantibodies tended to be higher among the COVID+ cohort. Conclusions: Positive APLA serology was associated with more severe disease regardless of COVID-19 status.

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“…Because SARS-CoV-2 is new to the human population, a range of immunological responses have been noted [ 1 ]. Some severely ill patients with COVID-19 have developed coagulopathies, and the relationship between a hypercoagulable state and the presence of anti-phospholipid antibodies is currently under debate [ 2 ]. We describe two patients with COVID-19 who developed pulmonary embolism and had transient anti-phospholipid antibodies, which were present during the acute illness but disappeared during recovery.…”

Section: Introductionmentioning

confidence: 99%

Transient Anti-Phospholipid Antibodies in Two Patients With COVID-19

Balanchivadze¹,

Xie²,

Kuriakose³

et al. 2021

Cureus

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We report two cases of coronavirus disease 2019 (COVID-19) in patients who developed pulmonary embolism and transient anti-phospholipid antibodies. At the time of presentation with acute pulmonary embolism, both patients had leukocytosis and increased levels of anti-cardiolipin antibodies, which resolved at testing 12 weeks after initial presentation. Studying cases of pulmonary embolism and increased anti-phospholipid antibodies in the context of COVID-19 could be one of the factors for elucidating the possible connection between severe acute respiratory syndrome coronavirus 2 infection, anti-phospholipid antibodies, and thrombosis.

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Anti-Phospholipid Antibodies in COVID-19 Are Different From Those Detectable in the Anti-Phospholipid Syndrome

Cited by 147 publications

References 37 publications

Autoimmune and Rheumatic Manifestations Associated With COVID-19 in Adults: An Updated Systematic Review

Autoimmune and Rheumatic Manifestations Associated With COVID-19 in Adults: An Updated Systematic Review

Anti-cardiolipin and other anti-phospholipid antibodies in critically ill COVID-19 positive and negative patients

Transient Anti-Phospholipid Antibodies in Two Patients With COVID-19

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