Department of Laboratory Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea.
Department of Laboratory Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, South Korea.
Int J Lab Hematol. 2023 Apr;45(2):163-169. doi: 10.1111/ijlh.14003. Epub 2022 Dec 10.
Lupus anticoagulant (LA) are commonly detected during SARS-CoV-2 infection. However, the relationship between LA and clinical significance is still unclear.
A retrospective chart analysis was performed on COVID-19 patients who were tested for LA at our hospital from March 2020 to November 2021. We analyzed the patient's characteristics based on the result of the LA test. In addition, subgroup analysis performed the LA-positive group who had undergone serial LA tests.
A total of 219 COVID-19 patients were enrolled in the study, 148 patients (67.6%) were positive for LA test. The LA-positive group received more treatment of high flow nasal cannula (LA-positive 73.0%, LA-negative 57.7%, p = 0.024). The LA-positive group showed prolonged aPTT, higher levels of CRP and fibrinogen (all p's < 0.05). Among 148 LA-positive patients, 127 patients (86.5%) were found to be LA-positive within 10 days of SARS-CoV-2 positive, and LA-positive group confirmed a median time to LA loss of 10 days. However, there was a group that was negative for LA in the early stages of infection and became positive about 13 days later. A subgroup analysis showed that these patients had different characteristics due to their longer hospital stays and higher D-dimer levels.
In COVID-19 patients, LA is expected to be associated to disease severity. Since the clinical significance of LA is different depending on the onset time of LA positivity, the LA test is suggested to be done at diagnosis of SARS-CoV-2 infection, even if LA is negative, follow-up test should be considered within 10 days.
狼疮抗凝物（lupus anticoagulant，LA）在 SARS-CoV-2 感染期间通常被检测到。然而，LA 与临床意义之间的关系仍不清楚。
对 2020 年 3 月至 2021 年 11 月在我院进行 LA 检测的 COVID-19 患者进行回顾性图表分析。我们根据 LA 检测结果分析患者的特征。此外，对 LA 阳性组进行了亚组分析，该组患者进行了连续的 LA 检测。
共纳入 219 例 COVID-19 患者，其中 148 例（67.6%）LA 检测阳性。LA 阳性组接受高流量鼻导管治疗的比例更高（LA 阳性组 73.0%，LA 阴性组 57.7%，p=0.024）。LA 阳性组的 aPTT 延长，CRP 和纤维蛋白原水平升高（均 p<0.05）。在 148 例 LA 阳性患者中，有 127 例（86.5%）在 SARS-CoV-2 阳性后 10 天内 LA 阳性，LA 阳性组 LA 转阴的中位时间为 10 天。然而，有一组患者在感染早期 LA 阴性，约 13 天后转为阳性。亚组分析显示，这些患者由于住院时间较长和 D-二聚体水平较高而具有不同的特征。
在 COVID-19 患者中，LA 预计与疾病严重程度相关。由于 LA 阳性的起始时间不同，其临床意义也不同，因此建议在 SARS-CoV-2 感染诊断时进行 LA 检测，即使 LA 阴性，也应在 10 天内考虑进行随访检测。
