Alijotas-Reig Jaume, Anunciación-Llunell Ariadna, Morales-Pérez Stephanie, Trapé Jaume, Esteve-Valverde Enrique, Miro-Mur Francesc
Systemic Autoimmune Diseases Research Unit, Vall d'Hebron Institut de Recerca (VHIR), 08035 Barcelona, Catalonia, Spain.
Systemic Autoimmune Diseases Unit, Department of Internal Medicine, Hospital Universitari Vall d'Hebron (HUVH), 08035 Barcelona, Catalonia, Spain.
Biomedicines. 2023 Aug 18;11(8):2301. doi: 10.3390/biomedicines11082301.
Antiphospholipid antibodies (APLA) are strongly associated with thrombosis seen in patients with antiphospholipid syndrome. In COVID-19, thrombosis has been observed as one of the main comorbidities. In patients hospitalised for COVID-19, we want to check whether APLA positivity is associated with COVID-19-related thrombosis, inflammation, severity of disease, or long COVID-19. We enrolled 92 hospitalised patients with COVID-19 between March and April 2020 who were tested for 18 different APLAs (IgG and IgM) with a single line-immunoassay test. A total of 30 healthy blood donors were used to set the cut-off for each APLA positivity. Of the 92 COVID-19 inpatients, 30 (32.61%; 95% CI [23.41-43.29]) tested positive for APLA, of whom 10 (33.3%; 95% CI [17.94-52.86]) had more than one APLA positivity. Anti-phosphatidylserine IgM positivity was described in 5.4% of inpatients ( = 5) and was associated with the occurrence of COVID-19-related thrombosis ( = 0.046). Anti-cardiolipin IgM positivity was the most prevalent among the inpatients ( = 12, 13.0%) and was associated with a recorded thrombosis in their clinical history ( = 0.044); however, its positivity was not associated with the occurrence of thrombosis during their hospitalisation for COVID-19. Anti-phosphatidylinositol IgM positivity, with a prevalence of 5.4% ( = 5), was associated with higher levels of interleukin (IL)-6 ( = 0.007) and ferritin ( = 0.034). Neither of these APLA positivities was a risk factor for COVID-19 severity or a predictive marker for long COVID-19. In conclusion, almost a third of COVID-19 inpatients tested positive for at least one APLA. Anti-phosphatidylserine positivity in IgM class was associated with thrombosis, and anti-phosphatidylinositol positivity in IgM class was associated with inflammation, as noticed by elevated levels of IL-6. Thus, testing for non-criteria APLA to assess the risk of clinical complications in hospitalised COVID-19 patients might be beneficial. However, they were not related to disease severity or long COVID-19.
抗磷脂抗体（APLA）与抗磷脂综合征患者出现的血栓形成密切相关。在新型冠状病毒肺炎（COVID-19）中，血栓形成已被视为主要的合并症之一。对于因COVID-19住院的患者，我们想检查APLA阳性是否与COVID-19相关的血栓形成、炎症、疾病严重程度或COVID-19长期症状有关。我们纳入了2020年3月至4月期间92例因COVID-19住院的患者，这些患者通过单一线免疫分析检测了18种不同的APLA（IgG和IgM）。总共30名健康献血者被用来设定每种APLA阳性的临界值。在92例COVID-19住院患者中，30例（32.61%；95%置信区间[23.41 - 43.29]）APLA检测呈阳性，其中10例（33.3%；95%置信区间[17.94 - 52.86]）有不止一种APLA阳性。5.4%的住院患者（n = 5）出现抗磷脂酰丝氨酸IgM阳性，且与COVID-19相关血栓形成的发生有关（P = 0.046）。抗心磷脂IgM阳性在住院患者中最为常见（n = 12，13.0%），且与他们临床病史中记录的血栓形成有关（P = 0.044）；然而，其阳性与他们因COVID-19住院期间血栓形成的发生无关。抗磷脂酰肌醇IgM阳性的患病率为5.4%（n = 5），与白细胞介素（IL）-6水平升高（P = 0.007）和铁蛋白水平升高（P = 0.034）有关。这些APLA阳性均不是COVID-19严重程度的危险因素，也不是COVID-19长期症状的预测指标。总之，近三分之一的COVID-19住院患者至少有一种APLA检测呈阳性。IgM类抗磷脂酰丝氨酸阳性与血栓形成有关，IgM类抗磷脂酰肌醇阳性与炎症有关，如IL-6水平升高所示。因此，检测非标准APLA以评估COVID-19住院患者临床并发症的风险可能是有益的。然而，它们与疾病严重程度或COVID-19长期症状无关。
