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In this single-center retrospective cohort study, the authors analyzed COVID-19 patients who had positive lupus anticoagulant (LA) testing. Overall, 44% of COVID-19 patients (30 of 68) tested positive for LA, whereas only 22% of COVID-19–negative patients (27 of 119) had positive LA testing. Nineteen of the 30 LA–positive patients with COVID-19 (63%) had arterial or venous thrombosis compared with 34% of LA–negative patients.
This study demonstrates an increased incidence of LA positivity in COVID-19 patients, as well as an increased rate of thrombosis.
– Derrick Tao, MD
This abstract is available on the publisher's site.
Antiphospholipid syndrome (APS) is an autoimmune disease that manifests as arterial, venous, or microcirculatory thromboses as well as obstetric complications.1 The diagnosis of APS requires the presence of IgG or IgM anti-β2-glycoprotein-1 or anticardiolipin antibodies by enzyme-linked immunosorbent assay or lupus anticoagulant (LA) assays that must persist for more than 12 weeks. Coagulopathy in patients with coronavirus disease 2019 (COVID-19) is a common complication that jeopardizes the clinical course and is associated with poorer outcomes.2,3 This COVID-19 coagulopathy presents mainly as a prothrombotic state, and there is evidence that anticoagulation may reduce mortality rates.4 The partial thromboplastin time (PTT) has been found to be prolonged in many patients with COVID-19 and may indicate the presence of LA.5 Most patients with COVID-19 have elevated levels of C-reactive protein (CRP), and CRP is known to interfere with LA PTT-based tests, such as the hexagonal phase phospholipid neutralization assay STACLOT-LA.6