Clinical Relevance of Antiphospholipid Antibodies Levels During the Course of Severe COVID-19

Soumia Nachate; Mahassine Moukaouim; Loubna Darfaoui; Zineb Nassiri; Imane Ibrahim; Houssam Rebahi; Hajar Chichou; Abdelhamid Hachimi; Mohamed-Abdenasser Semkaoui; Raja Hazime; Lamiae Essaadouni; Brahim Admou

doi:doi:10.11648/j.iji.20210902.13

Clinical Relevance of Antiphospholipid Antibodies Levels During the Course of Severe COVID-19

Soumia Nachate, Mahassine Moukaouim, Loubna Darfaoui, Zineb Nassiri, Imane Ibrahim, Houssam Rebahi, Hajar Chichou, Abdelhamid Hachimi, Mohamed-Abdenasser Semkaoui, Raja Hazime, Lamiae Essaadouni, Brahim Admou

Published in International Journal of Immunology (Volume 9, Issue 2)

Received: 18 April 2021 Accepted: 6 May 2021 Published: 14 May 2021

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Abstract

The aim of this study was to determine the clinical significance of antiphospholipid antibodies (APLs) during the follow-up of nine severe COVID-19 patients admitted to the Intensive Care Unit of the University Hospital. The measurement of APLs (IgG and IgM anti-cardiolipin (aCL) and anti-β2-glycoprotein-1 (aB2GP1) was performed on the 1st day and after 15 days of admission, using the chemiluminescence assay (threshold =19 CU). The average age of patients was 64.7 ± 20, 44 years (ranges: 30-88 years), with a sex-ratio of 1.25. On day-1, APLs were positive in two cases, the first of which was positive for IgG aβ2GP1 (94.9 CU) and IgG aCL (24.8 CU), and the second was positive only for IgG aβ2GP1 (31.4 CU). On day-15, APLs showed negative results for both aβ2GP1 and aCL for the first case, and decreasing titers of aβ2GP1 for the second one. Interestingly, these two cases showed no thromboembolic events and had a good clinical outcome. Conversely, APL positivity occurred at day-15 in two cases, corresponding to IgG aB2GPI (49.3 CU) in one case, and IgG aCL (76 CU) in the other. Both cases presented with a prolonged activated-partial-thromboplastin-time, high levels of D-dimers and fibrinogen, associated with increased levels of ferritin and interleukin-6. Our series has shown that IgG aB2GPI or IgG aCL can be either transient or appear secondarily with significantly high titers. The latter condition was associated with a poor clinical outcome, which emphasizes the importance of APLs monitoring in severe COVID-19 as a potential prognostic factor.

Published in	International Journal of Immunology (Volume 9, Issue 2)
DOI	10.11648/j.iji.20210902.13
Page(s)	37-40
Creative Commons	This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.
Copyright	Copyright © The Author(s), 2021. Published by Science Publishing Group

Keywords

Severe COVID-19, Anti-phospholipid Antibodies, Monitoring, Prognosis

References

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[2]	Sung J, Anjum S. (2020). Coronavirus Disease 2019 (COVID-19) Infection Associated With Antiphospholipid Antibodies and Four-Extremity Deep Vein thrombosis in a Previously Healthy Female. Cureus. 12 (6): e8408.
[3]	Tang N, Li D, Wang X, Sun Z. (2020). Abnormal coagulation parameters are associated with poor prognosis in patients with novel coronavirus pneumonia. J Thromb Haemost. 18 (4): 844-847.
[4]	Borghi MO, Beltagy A, Garrafa E, Curreli D, Cecchini G, Bodio C. (2020). Anti-Phospholipid Antibodies in COVID-19 Are Different From Those Detectable in the AntiPhospholipid Syndrome. Front. Immunol. 11: 584241.
[5]	Tektonidou MG, Andreoli L, Limper M, et al. (2019). EULAR recommendations for the management of antiphospholipid syndrome in adults. Annals of the Rheumatic Diseases. 78 (10): 1296-1304.
[6]	Zhang Y, Xiao M, Zhang S, Xia P, Cao W, Jiang W, et al. (2020). Coagulopathy and Antiphospholipid Antibodies in Patients with Covid-19. N Engl J Med. 382 (17): e38.
[7]	Xiao M, Zhang Y, Zhang S, Qin X, Xia P, Cao W, et al. (2020). Brief Report: Anti-phospholipid antibodies in critically ill patients with Coronavirus Disease 2019 (COVID-19). Arthritis Rheumatol. 72(12): 1998-2004.
[8]	Pineton de Chambrun M, Frere C, Miyara M, Amoura Z, Martin-Toutain I, Mathian A, et al. (2021). High frequency of antiphospholipid antibodies in critically ill COVID-19 patients: a link with hypercoagulability? (Letter To The Editor). Journal of Internal Medicine. 289: 422–424.
[9]	Wichmann D, Sperhake J-P, Lütgehetmann M, Steurer S, Edler C, Heinemann A, et al. (2020). Autopsy findings and venous thromboembolism in patients with COVID-19. Ann Intern Med. 173 (4): 268-77.
[10]	Amezcua-Guerra LM, Rojas-Velasco G, Brianza-Padilla M, et al. (2021). Presence of antiphospholipid antibodies in COVID-19: a case series study. Annals of the Rheumatic Diseases. 80: e73.
[11]	Le Joncour A, Frere C, Martin-Toutain I. (2021). Antiphospholipid antibodies and thrombotic events in COVID-19 patients hospitalized in medicine ward. Autoimmun Rev. 20 (2): 102729.
[12]	Zuo Y, Estes SK, Gandhi AA, Yalavarthi S, Ali RA, Lezak SP, et al. (2020). Prothrombotic autoantibodies in serum from patients hospitalized with COVID-19. Sci Transl Med. 12 (570): eabd3876.
[13]	Zuo Y, Kanthi Y, Knight JS, Zuo Y, Yalavarthi S, Shi H, et al. (2020). Neutrophil extracellular traps in COVID-19 Neutrophil extracellular traps in COVID-19. JCI Insight. 5 (11): e138999.
[14]	Devreese KMJ, Linskens EA, Benoit D, Peperstraete H. (2020). Antiphospholipid antibodies in patients with COVID-19: A relevant observation? J Thromb Haemost. 18 (9): 2191-2201.
[15]	Galeano-Valle F, Oblitas CM, Ferreiro-Mazón MM, Alonso-Muñoz J, Del Toro-Cervera J, di Natale M, Demelo-Rodríguez P. (2020). Antiphospholipid antibodies are not elevated in patients with severe COVID-19 pneumonia and venous thromboembolism. Thromb Res. 192: 113-115.
[16]	Mendoza- Pinto C, García- Carrasco M, Cervera R. (2018). Role of infectious diseases in the antiphospholipid syndrome (including its catastrophic variant). Curr Rheumatol Rep. 20, 62.
[17]	Abdel-Wahab N, Talathi S, Lopez-Olivo MA, Suarez-Almazor ME. (2018). Risk of developing antiphospholipid antibodies following viral infection: a systematic review and meta-analysis. Lupus. 27, 572-583.
[18]	Mehta S, Bhandari S, Mehta S. (2020). Cautious interpretation of antiphospholipid antibodies in COVID-19. Clinica Chimica Acta. 509, 166.
[19]	Bertin D, Brodovitch A, Beziane A, Hug S, Bouamri A, Mege J. L, et al. (2020), Anticardiolipin IgG Autoantibody Level Is an Independent Risk Factor for COVID‐19 Severity. Arthritis Rheumatol. 72: 1953-1955.

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APA Style

Soumia Nachate, Mahassine Moukaouim, Loubna Darfaoui, Zineb Nassiri, Imane Ibrahim, et al. (2021). Clinical Relevance of Antiphospholipid Antibodies Levels During the Course of Severe COVID-19. International Journal of Immunology, 9(2), 37-40. https://doi.org/10.11648/j.iji.20210902.13

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ACS Style

Soumia Nachate; Mahassine Moukaouim; Loubna Darfaoui; Zineb Nassiri; Imane Ibrahim, et al. Clinical Relevance of Antiphospholipid Antibodies Levels During the Course of Severe COVID-19. Int. J. Immunol. 2021, 9(2), 37-40. doi: 10.11648/j.iji.20210902.13

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AMA Style

Soumia Nachate, Mahassine Moukaouim, Loubna Darfaoui, Zineb Nassiri, Imane Ibrahim, et al. Clinical Relevance of Antiphospholipid Antibodies Levels During the Course of Severe COVID-19. Int J Immunol. 2021;9(2):37-40. doi: 10.11648/j.iji.20210902.13

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@article{10.11648/j.iji.20210902.13,
  author = {Soumia Nachate and Mahassine Moukaouim and Loubna Darfaoui and Zineb Nassiri and Imane Ibrahim and Houssam Rebahi and Hajar Chichou and Abdelhamid Hachimi and Mohamed-Abdenasser Semkaoui and Raja Hazime and Lamiae Essaadouni and Brahim Admou},
  title = {Clinical Relevance of Antiphospholipid Antibodies Levels During the Course of Severe COVID-19},
  journal = {International Journal of Immunology},
  volume = {9},
  number = {2},
  pages = {37-40},
  doi = {10.11648/j.iji.20210902.13},
  url = {https://doi.org/10.11648/j.iji.20210902.13},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.iji.20210902.13},
  abstract = {The aim of this study was to determine the clinical significance of antiphospholipid antibodies (APLs) during the follow-up of nine severe COVID-19 patients admitted to the Intensive Care Unit of the University Hospital. The measurement of APLs (IgG and IgM anti-cardiolipin (aCL) and anti-β2-glycoprotein-1 (aB2GP1) was performed on the 1st day and after 15 days of admission, using the chemiluminescence assay (threshold =19 CU). The average age of patients was 64.7 ± 20, 44 years (ranges: 30-88 years), with a sex-ratio of 1.25. On day-1, APLs were positive in two cases, the first of which was positive for IgG aβ2GP1 (94.9 CU) and IgG aCL (24.8 CU), and the second was positive only for IgG aβ2GP1 (31.4 CU). On day-15, APLs showed negative results for both aβ2GP1 and aCL for the first case, and decreasing titers of aβ2GP1 for the second one. Interestingly, these two cases showed no thromboembolic events and had a good clinical outcome. Conversely, APL positivity occurred at day-15 in two cases, corresponding to IgG aB2GPI (49.3 CU) in one case, and IgG aCL (76 CU) in the other. Both cases presented with a prolonged activated-partial-thromboplastin-time, high levels of D-dimers and fibrinogen, associated with increased levels of ferritin and interleukin-6. Our series has shown that IgG aB2GPI or IgG aCL can be either transient or appear secondarily with significantly high titers. The latter condition was associated with a poor clinical outcome, which emphasizes the importance of APLs monitoring in severe COVID-19 as a potential prognostic factor.},
 year = {2021}
}

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TY  - JOUR
T1  - Clinical Relevance of Antiphospholipid Antibodies Levels During the Course of Severe COVID-19
AU  - Soumia Nachate
AU  - Mahassine Moukaouim
AU  - Loubna Darfaoui
AU  - Zineb Nassiri
AU  - Imane Ibrahim
AU  - Houssam Rebahi
AU  - Hajar Chichou
AU  - Abdelhamid Hachimi
AU  - Mohamed-Abdenasser Semkaoui
AU  - Raja Hazime
AU  - Lamiae Essaadouni
AU  - Brahim Admou
Y1  - 2021/05/14
PY  - 2021
N1  - https://doi.org/10.11648/j.iji.20210902.13
DO  - 10.11648/j.iji.20210902.13
T2  - International Journal of Immunology
JF  - International Journal of Immunology
JO  - International Journal of Immunology
SP  - 37
EP  - 40
PB  - Science Publishing Group
SN  - 2329-1753
UR  - https://doi.org/10.11648/j.iji.20210902.13
AB  - The aim of this study was to determine the clinical significance of antiphospholipid antibodies (APLs) during the follow-up of nine severe COVID-19 patients admitted to the Intensive Care Unit of the University Hospital. The measurement of APLs (IgG and IgM anti-cardiolipin (aCL) and anti-β2-glycoprotein-1 (aB2GP1) was performed on the 1st day and after 15 days of admission, using the chemiluminescence assay (threshold =19 CU). The average age of patients was 64.7 ± 20, 44 years (ranges: 30-88 years), with a sex-ratio of 1.25. On day-1, APLs were positive in two cases, the first of which was positive for IgG aβ2GP1 (94.9 CU) and IgG aCL (24.8 CU), and the second was positive only for IgG aβ2GP1 (31.4 CU). On day-15, APLs showed negative results for both aβ2GP1 and aCL for the first case, and decreasing titers of aβ2GP1 for the second one. Interestingly, these two cases showed no thromboembolic events and had a good clinical outcome. Conversely, APL positivity occurred at day-15 in two cases, corresponding to IgG aB2GPI (49.3 CU) in one case, and IgG aCL (76 CU) in the other. Both cases presented with a prolonged activated-partial-thromboplastin-time, high levels of D-dimers and fibrinogen, associated with increased levels of ferritin and interleukin-6. Our series has shown that IgG aB2GPI or IgG aCL can be either transient or appear secondarily with significantly high titers. The latter condition was associated with a poor clinical outcome, which emphasizes the importance of APLs monitoring in severe COVID-19 as a potential prognostic factor.
VL  - 9
IS  - 2
ER  -

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Author Information

Soumia Nachate

Laboratory of Immunology, Department of Biology, Mohamed VI University Hospital, Faculty of Medicine and Pharmacy of Marrakech, Cadi Ayyad University, Marrakech, Morocco
Mahassine Moukaouim

Laboratory of Immunology, Department of Biology, Mohamed VI University Hospital, Faculty of Medicine and Pharmacy of Marrakech, Cadi Ayyad University, Marrakech, Morocco
Loubna Darfaoui

Laboratory of Immunology, Department of Biology, Mohamed VI University Hospital, Faculty of Medicine and Pharmacy of Marrakech, Cadi Ayyad University, Marrakech, Morocco
Zineb Nassiri

Laboratory of Immunology, Department of Biology, Mohamed VI University Hospital, Faculty of Medicine and Pharmacy of Marrakech, Cadi Ayyad University, Marrakech, Morocco
Imane Ibrahim

Laboratory of Immunology, Department of Biology, Mohamed VI University Hospital, Faculty of Medicine and Pharmacy of Marrakech, Cadi Ayyad University, Marrakech, Morocco
Houssam Rebahi

Department of Anesthesia and Intensive Care, Mohamed VI University Hospital, Faculty of Medicine and Pharmacy of Marrakech, Cadi Ayyad University, Marrakech, Morocco
Hajar Chichou

Department of Anesthesia and Intensive Care, Mohamed VI University Hospital, Faculty of Medicine and Pharmacy of Marrakech, Cadi Ayyad University, Marrakech, Morocco
Abdelhamid Hachimi

Department of Anesthesia and Intensive Care, Mohamed VI University Hospital, Faculty of Medicine and Pharmacy of Marrakech, Cadi Ayyad University, Marrakech, Morocco
Mohamed-Abdenasser Semkaoui

Department of Anesthesia and Intensive Care, Mohamed VI University Hospital, Faculty of Medicine and Pharmacy of Marrakech, Cadi Ayyad University, Marrakech, Morocco
Raja Hazime

Laboratory of Immunology, Department of Biology, Mohamed VI University Hospital, Faculty of Medicine and Pharmacy of Marrakech, Cadi Ayyad University, Marrakech, Morocco
Lamiae Essaadouni

Department of Internal Medicine, Mohamed VI University Hospital, Faculty of Medicine and Pharmacy of Marrakech, Cadi Ayyad University, Marrakech, Morocco
Brahim Admou

Laboratory of Immunology, Department of Biology, Mohamed VI University Hospital, Faculty of Medicine and Pharmacy of Marrakech, Cadi Ayyad University, Marrakech, Morocco

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APA Style

Soumia Nachate, Mahassine Moukaouim, Loubna Darfaoui, Zineb Nassiri, Imane Ibrahim, et al. (2021). Clinical Relevance of Antiphospholipid Antibodies Levels During the Course of Severe COVID-19. International Journal of Immunology, 9(2), 37-40. https://doi.org/10.11648/j.iji.20210902.13

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ACS Style

Soumia Nachate; Mahassine Moukaouim; Loubna Darfaoui; Zineb Nassiri; Imane Ibrahim, et al. Clinical Relevance of Antiphospholipid Antibodies Levels During the Course of Severe COVID-19. Int. J. Immunol. 2021, 9(2), 37-40. doi: 10.11648/j.iji.20210902.13

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AMA Style

Soumia Nachate, Mahassine Moukaouim, Loubna Darfaoui, Zineb Nassiri, Imane Ibrahim, et al. Clinical Relevance of Antiphospholipid Antibodies Levels During the Course of Severe COVID-19. Int J Immunol. 2021;9(2):37-40. doi: 10.11648/j.iji.20210902.13

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@article{10.11648/j.iji.20210902.13,
  author = {Soumia Nachate and Mahassine Moukaouim and Loubna Darfaoui and Zineb Nassiri and Imane Ibrahim and Houssam Rebahi and Hajar Chichou and Abdelhamid Hachimi and Mohamed-Abdenasser Semkaoui and Raja Hazime and Lamiae Essaadouni and Brahim Admou},
  title = {Clinical Relevance of Antiphospholipid Antibodies Levels During the Course of Severe COVID-19},
  journal = {International Journal of Immunology},
  volume = {9},
  number = {2},
  pages = {37-40},
  doi = {10.11648/j.iji.20210902.13},
  url = {https://doi.org/10.11648/j.iji.20210902.13},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.iji.20210902.13},
  abstract = {The aim of this study was to determine the clinical significance of antiphospholipid antibodies (APLs) during the follow-up of nine severe COVID-19 patients admitted to the Intensive Care Unit of the University Hospital. The measurement of APLs (IgG and IgM anti-cardiolipin (aCL) and anti-β2-glycoprotein-1 (aB2GP1) was performed on the 1st day and after 15 days of admission, using the chemiluminescence assay (threshold =19 CU). The average age of patients was 64.7 ± 20, 44 years (ranges: 30-88 years), with a sex-ratio of 1.25. On day-1, APLs were positive in two cases, the first of which was positive for IgG aβ2GP1 (94.9 CU) and IgG aCL (24.8 CU), and the second was positive only for IgG aβ2GP1 (31.4 CU). On day-15, APLs showed negative results for both aβ2GP1 and aCL for the first case, and decreasing titers of aβ2GP1 for the second one. Interestingly, these two cases showed no thromboembolic events and had a good clinical outcome. Conversely, APL positivity occurred at day-15 in two cases, corresponding to IgG aB2GPI (49.3 CU) in one case, and IgG aCL (76 CU) in the other. Both cases presented with a prolonged activated-partial-thromboplastin-time, high levels of D-dimers and fibrinogen, associated with increased levels of ferritin and interleukin-6. Our series has shown that IgG aB2GPI or IgG aCL can be either transient or appear secondarily with significantly high titers. The latter condition was associated with a poor clinical outcome, which emphasizes the importance of APLs monitoring in severe COVID-19 as a potential prognostic factor.},
 year = {2021}
}

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TY  - JOUR
T1  - Clinical Relevance of Antiphospholipid Antibodies Levels During the Course of Severe COVID-19
AU  - Soumia Nachate
AU  - Mahassine Moukaouim
AU  - Loubna Darfaoui
AU  - Zineb Nassiri
AU  - Imane Ibrahim
AU  - Houssam Rebahi
AU  - Hajar Chichou
AU  - Abdelhamid Hachimi
AU  - Mohamed-Abdenasser Semkaoui
AU  - Raja Hazime
AU  - Lamiae Essaadouni
AU  - Brahim Admou
Y1  - 2021/05/14
PY  - 2021
N1  - https://doi.org/10.11648/j.iji.20210902.13
DO  - 10.11648/j.iji.20210902.13
T2  - International Journal of Immunology
JF  - International Journal of Immunology
JO  - International Journal of Immunology
SP  - 37
EP  - 40
PB  - Science Publishing Group
SN  - 2329-1753
UR  - https://doi.org/10.11648/j.iji.20210902.13
AB  - The aim of this study was to determine the clinical significance of antiphospholipid antibodies (APLs) during the follow-up of nine severe COVID-19 patients admitted to the Intensive Care Unit of the University Hospital. The measurement of APLs (IgG and IgM anti-cardiolipin (aCL) and anti-β2-glycoprotein-1 (aB2GP1) was performed on the 1st day and after 15 days of admission, using the chemiluminescence assay (threshold =19 CU). The average age of patients was 64.7 ± 20, 44 years (ranges: 30-88 years), with a sex-ratio of 1.25. On day-1, APLs were positive in two cases, the first of which was positive for IgG aβ2GP1 (94.9 CU) and IgG aCL (24.8 CU), and the second was positive only for IgG aβ2GP1 (31.4 CU). On day-15, APLs showed negative results for both aβ2GP1 and aCL for the first case, and decreasing titers of aβ2GP1 for the second one. Interestingly, these two cases showed no thromboembolic events and had a good clinical outcome. Conversely, APL positivity occurred at day-15 in two cases, corresponding to IgG aB2GPI (49.3 CU) in one case, and IgG aCL (76 CU) in the other. Both cases presented with a prolonged activated-partial-thromboplastin-time, high levels of D-dimers and fibrinogen, associated with increased levels of ferritin and interleukin-6. Our series has shown that IgG aB2GPI or IgG aCL can be either transient or appear secondarily with significantly high titers. The latter condition was associated with a poor clinical outcome, which emphasizes the importance of APLs monitoring in severe COVID-19 as a potential prognostic factor.
VL  - 9
IS  - 2
ER  -

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