Rostami Mehrdad, Parsa-Kondelaji Mohammad, Bos Mettine H A, Mansouritorghabeh Hassan
Departments of Hematology and Blood Banking, Faculty of Allied Medicine, Iran University of Medical Sciences, Tehran, Iran.
Department of Basic Medical Sciences, Neyshabur University of Medical Sciences, Neyshabur, Iran.
J Thromb Thrombolysis. 2025 Jul 5. doi: 10.1007/s11239-025-03116-z.
COVID-19 patients are at an increased risk of developing thrombotic events, with venous thromboembolism (VTE) occurring in 16% and arterial thrombosis in 11.1% of cases. This systematic review and meta-analysis aimed to explore the prevalence of anti-phospholipid antibodies (aPLs) in COVID-19 patients and their potential role in thrombotic complications. A comprehensive literature search across PubMed, Scopus, and Web of Science identified 48 studies from an initial pool of 1,819 articles, which met the inclusion criteria and were rigorously evaluated for methodological quality. The analysis of studies revealed varying prevalence rates of aPLs among COVID-19 patients. Anti-β2 glycoprotein I IgM (aβ2GPI-IgM) was found in 5.3% of 5,176 patients, while aβ2GPI-IgG was observed in 3.6% of 5,348 patients. In contrast, aβ2GPI-IgA showed a higher prevalence of 10.8% across 18 studies involving 1,930 patients. Anti-cardiolipin antibodies also demonstrated distinct prevalence rates: aCL-IgG was present in 7.2% of 5,478 patients, aCL-IgM in 6.7% of 5,485 patients, and aCL-IgA in 4.7% of 1,626 patients. Notably, lupus anticoagulant (LA) had the highest pooled prevalence rate of 27.2% across 16 studies involving 1,731 patients. Among the aPL subgroups, LA were the most frequently detected, which may be due to interference of C-reactive protein (CRP). The findings underscore the heterogeneity in aPL distribution and emphasize the need for further research to clarify their role in the thrombotic manifestations of COVID-19. These insights may aid in prevention of thrombotic events by administration of anticoagulants in affected patients. PROSPERO REGISTRATION NUMBER: CRD42024529786.
新冠病毒病（COVID-19）患者发生血栓事件的风险增加，静脉血栓栓塞（VTE）发生率为16%，动脉血栓形成发生率为11.1%。本系统评价和荟萃分析旨在探讨COVID-19患者中抗磷脂抗体（aPLs）的患病率及其在血栓形成并发症中的潜在作用。通过对PubMed、Scopus和Web of Science进行全面的文献检索，从最初的1819篇文章中筛选出48项研究，这些研究符合纳入标准，并对其方法学质量进行了严格评估。对研究的分析显示，COVID-19患者中aPLs的患病率各不相同。在5176例患者中，5.3%检测到抗β2糖蛋白I IgM（aβ2GPI-IgM），而在5348例患者中，3.6%检测到aβ2GPI-IgG。相比之下，在涉及1930例患者的18项研究中，aβ2GPI-IgA的患病率较高，为10.8%。抗心磷脂抗体也显示出不同的患病率：aCL-IgG在5478例患者中占7.2%，aCL-IgM在5485例患者中占6.7%，aCL-IgA在1626例患者中占4.7%。值得注意的是，在涉及1731例患者的16项研究中，狼疮抗凝物（LA）的合并患病率最高，为27.2%。在aPL亚组中，LA是最常检测到的，这可能是由于C反应蛋白（CRP）的干扰。这些发现强调了aPL分布的异质性，并强调需要进一步研究以阐明它们在COVID-19血栓形成表现中的作用。这些见解可能有助于通过对受影响患者使用抗凝剂来预防血栓事件。PROSPERO注册号：CRD42024529786。
