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住院COVID-19患者中狼疮抗凝物的发生率。

Incidence of lupus anticoagulant in hospitalized covid-19 patients.

作者信息

Owaidah Tarek, Saleh Mahasen, Aguilos Amelita M, Amri Abdulllah Al, Maghrabi Khalid, Owaidah Mustafa, Siddiqui Khawar, Alsaleh Khalid, Alnounou Randa

机构信息

Department of Pathology and Laboratory Medicine, King Faisal Specialist Hospital and Research Centre Riyadh 11211, KSA.

Alfaisal University Riyadh 11533, KSA.

出版信息

Am J Blood Res. 2021 Jun 15;11(3):317-324. eCollection 2021.

Abstract

BACKGROUND

Procoagulant profile of 2019-nCoV/SARS-CoV-2 has been well documented over the last year. Perturbance in coagulating factors has also been reported in Covid-19 patients, including increased d-dimers and reports of lupus anticoagulant (LA).

METHODS

The current study aimed to identify the incidence of positivity of lupus anticoagulant in Covid-19 patients and analyze the association between LA and D-dimer in predicting thrombosis and mortality in one-hundred and five hospitalized adult (age >14 years) patients and forty-three hospitalized pediatric (age <14 years) patients with a confirmed diagnosis of Covid-19 between June 2020 and September 2020.

RESULTS

Twenty-one (20%) adult patients were tested positive for PTT LA, of which nine (8.6%) turned out to be confirmed positive for LA through StaClot and DRVVT Ratio tests. Six (14%) pediatric patients were positive for PTT LA, and only one (2.3%) had positive StaClot. Median D-dimer at admission was positively correlated with age and CRP among adult patients and was significantly higher in expired cases (P=0.001). No association between any of the coagulation tests and thrombosis or mortality was observed in the pediatric cohort.

CONCLUSION

We report an increased incidence of LA in Covid-19 patients, yet we didn't find any association between thrombotic events or mortality, probably due to the small sample size.

摘要

背景

在过去一年中,2019新型冠状病毒/严重急性呼吸综合征冠状病毒2(SARS-CoV-2)的促凝血特征已有充分记录。新冠病毒疾病(Covid-19)患者中也有凝血因子紊乱的报道,包括D-二聚体升高以及狼疮抗凝物(LA)的相关报道。

方法

本研究旨在确定Covid-19患者中狼疮抗凝物阳性的发生率,并分析狼疮抗凝物与D-二聚体之间的关联,以预测2020年6月至2020年9月期间确诊为Covid-19的105例住院成年(年龄>14岁)患者和43例住院儿科(年龄<14岁)患者的血栓形成和死亡率。

结果

21例(20%)成年患者部分凝血活酶时间狼疮抗凝物(PTT LA)检测呈阳性,其中9例(8.6%)通过StaClot和稀释蝰蛇毒时间(DRVVT)比率检测确诊为狼疮抗凝物阳性。6例(14%)儿科患者PTT LA呈阳性,只有1例(2.3%)StaClot呈阳性。成年患者入院时D-二聚体中位数与年龄和C反应蛋白(CRP)呈正相关,在死亡病例中显著更高(P=0.001)。儿科队列中未观察到任何凝血检测与血栓形成或死亡率之间的关联。

结论

我们报告了Covid-19患者中狼疮抗凝物发生率增加,但未发现血栓形成事件或死亡率之间存在任何关联,可能是由于样本量较小。

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Lupus anticoagulant and mortality in patients hospitalized for COVID-19.狼疮抗凝物与 COVID-19 住院患者的死亡率。
J Thromb Thrombolysis. 2021 Jul;52(1):85-91. doi: 10.1007/s11239-020-02335-w. Epub 2020 Nov 7.
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Coagulopathy of Coronavirus Disease 2019.新型冠状病毒疾病的凝血功能障碍。
Crit Care Med. 2020 Sep;48(9):1358-1364. doi: 10.1097/CCM.0000000000004458.

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