Background and Aims

Antiphospholipid antibodies (aPL) occurrence was described in many infectious diseases, severe acute respiratory syndrome coronavirus 2 (SARS‑CoV‑2) included. Coronavirus Disease 2019 (COVID-19) may complicate with coagulopathy and high rate of thrombosis, context in which the aPL involvement was questioned.

Methods

Single-center study including patients diagnosed with COVID-19 based on a positive RT-PCR SARS-CoV2 test. In all patients, data regarding the lupus anticoagulant (LAC), anti-cardiolipin (ACA) IgG, ACA IgM, and anti-b2-glycoprotein 1 (anti-b2GPI) IgG antibodies, as well as clinical and laboratory data were collected.

Results

179 COVID-19 patients (55.3% female, age 59.6±14.5years) were successively included.

Cough (63.7%), fever (59.2%), and myalgia (41.9%) were the most frequent symptoms. Regarding disease severity, 45 patients (25.1%) had mild, 62 patients (34.6%) moderate, while 72 patients (40.2%) severe disease, respectively.

Moderately positive LAC level was found in 75/172 (41.9%), while intensely positive level in 8/172 (4.5%) cases. ACA IgM, ACA IgG, and anti-b2GPI IgG were identified in 17/174 (9.5%), 8/167 (4.5%), and 3/172 (1.7%) COVID-19 cases, respectively.

LAC was significantly associated with D-dimers (p=0.016), aPTT (p=0.001), ferritin (p=0.004), C-reactive protein (p=0.001) levels, and inversely related to lymphocytes (p=0.007) and platelets number (p<0.001). LAC was also more frequent expressed in severe when compared to moderate or mild COVID-19 (p=0.027). Moreover, ACA IgM and anti-b2GPI IgG titers were correlated to the D-dimers levels, p=0.032 and p=0.026, respectively.

Conclusions

In our study, LAC was the most common aPL identified in COVID-19 and also its expression was found to be correlated to disease severity.