Does COVID-19 infection or COVID-19 mRNA vaccination induce antiphospholipid antibodies in women with recurrent pregnancy loss?

Abstract

Antiphospholipid syndrome (APS) is a well-established cause of recurrent pregnancy loss (RPL). If coronavirus disease 2019 (COVID-19) infection or vaccination induces antiphospholipid antibody (aPL) production, it may lead to miscarriage in subsequent pregnancies. We investigated the association between COVID-19 infection and vaccination history with aPL positivity in women with RPL. This study included 424 women with RPL. We found no difference in the positivity rate for aPL according to the presence or absence of a history of COVID-19 infection. The positivity rate was significantly higher in patients infected during the omicron period (27.9 %, 43/154) than in those infected during the delta period (8.7 %, 2/23) of the COVID-19 pandemic (P = 0.0351). Of the 416 patients with a detailed vaccination history, 365 (87.7 %) had received at least one vaccination. The aPL positivity rate did not significantly differ according to the history of vaccination or number of vaccinations. Our results suggest that mild COVID-19 infection and vaccination are unlikely to stimulate aPL production and, therefore, are unlikely to increase miscarriage due to APS.