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COVID-19 相关肺炎重症监护病房患者中的抗磷脂抗体。

Antiphospholipid antibodies in COVID-19-associated pneumonia patients in intensive care unit.

机构信息

Department of Internal Medicine, Division of Rheumatology, Kayseri City Education and Research Hospital, Kayseri, Turkey.

Department of Physical Medicine and Rehabilitation, Division of Rheumatology, Kayseri City Education and Research Hospital, Kayseri, Turkey.

出版信息

Mod Rheumatol. 2022 Jan 5;32(1):163-168. doi: 10.1080/14397595.2021.1892257.

Abstract

OBJECTIVES

Antiphospholipid antibodies (APAs) increase the risk of excessive blood clotting, but their role in COVID-19 remains unclear. We aimed to investigate the presence of conventional APAs used in the classification of antiphospholipid antibody syndrome in patients with severe lung infection with SARS-CoV-2 and to compare these results with non-COVID-19 critically ill patients.

METHODS

Thirty-one COVID-19 patients (COVID group) and 28 non-COVID-19 critically ill patients (non-COVID group), were included in the study. Anti-cardiolipin (ACA) (IgG, IgM), anti-β2-glycoprotein 1 (Anti-β2GPI) (IgG, IgM, and IgA), and if the patient had not received any anti thrombotic agent before blood collection, lupus anticoagulant (LAC) tests were studied from the plasma of the patients. For testing ACA and Anti-β2GPI, ELISA method was used, while fully automated coagulometer device was used for LAC test.

RESULTS

APAs were positive in 25.81% in the COVID group (8/31) and 25% in the non-COVID group (7/28). LAC was the most common APA present in 23.08% of the COVID-19 group, who underwent measurement (6/26), while 3.57% of the non-COVID group was LAC positive (1/28) (p = .047). In the COVID group, ACA IgM, and IgG were positive in 6.45% and 0%, respectively (2/31 vs 0/31). In the non-COVID group, ACA IgM was not positive in any patient, while ACA IgG was positive in 7.14% (2/28). Anti-β2GPI IgG and IgM tests were not positive in any patient in either the COVID or the non-COVID group. Anti-β2GPI IgA were positive in 6.45% and 14.29%, respectively (2/31 vs 4/28).

CONCLUSION

In this study, APAs were equally positive in critically ill patients among COVID-19 or non-COVID-19 patients. Only LAC was more observed in COVID-19 patients.

摘要

目的

抗磷脂抗体(APAs)会增加过度凝血的风险,但它们在 COVID-19 中的作用仍不清楚。我们旨在研究用于诊断抗磷脂抗体综合征的常规 APA 在严重感染 SARS-CoV-2 的肺部感染患者中的存在情况,并将这些结果与非 COVID-19 危重症患者进行比较。

方法

本研究纳入了 31 名 COVID-19 患者(COVID 组)和 28 名非 COVID-19 危重症患者(非 COVID 组)。从患者血浆中研究了抗心磷脂(ACA)(IgG、IgM)、抗β2-糖蛋白 1(Anti-β2GPI)(IgG、IgM 和 IgA),以及如果患者在采血前未接受任何抗血栓药物治疗,则研究狼疮抗凝剂(LAC)检测。ACA 和 Anti-β2GPI 检测采用 ELISA 法,LAC 检测采用全自动凝血仪。

结果

COVID 组 APA 阳性率为 25.81%(8/31),非 COVID 组为 25%(7/28)。LAC 是 COVID-19 组中最常见的 APA,有 23.08%(6/26)接受了检测,而非 COVID 组中只有 3.57%(1/28)为 LAC 阳性(p=0.047)。在 COVID 组中,ACA IgM 和 IgG 阳性率分别为 6.45%和 0%(2/31 与 0/31)。在非 COVID 组中,ACA IgM 未在任何患者中阳性,而 ACA IgG 阳性率为 7.14%(2/28)。COVID 或非 COVID 组患者的 Anti-β2GPI IgG 和 IgM 检测均未阳性。Anti-β2GPI IgA 阳性率分别为 6.45%和 14.29%(2/31 与 4/28)。

结论

在这项研究中,COVID-19 或非 COVID-19 危重症患者中 APA 的阳性率相当。仅 LAC 在 COVID-19 患者中更为常见。

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