Dissecting the Thrombotic Events in the Presence of Antiphospholipid Antibodies in COVID-19 Spanish Patients

Abstract

Several thrombotic complications in patients affected with SARS-CoV-2 have been reported. Single-centre pilot study aimed to analyse the coexistence of antiphospholipid antibodies and thrombotic events on SARS-CoV-2 infected patients. Antiphospholipid antibodies were measured by solid phase enzyme immunoassay. Clinical data were collected from electronic history and clinical records. Over 25 patients studied we report four cases of COVID-19 patients who presented circulating antiphospholipid antibodies and arterial or venous thrombotic events. No patient had a previous history of thrombosis. Two cases presented with pulmonary embolism, one with pulmonary embolism and pulmonary infarction and one with a stroke. All of them showed positive anti-cardiolipin antibodies. One patient died and three were discharged. The presence of antiphospholipid antibodies in these patients might represent an epiphenomenon secondary to the immune stimulation by the virus. It could be reasonable to consider measuring antiphospholipid antibodies as part of the study of a thrombotic event in COVID-19 patients to better understand the impact of these antibodies in the development of thrombotic events and we highlight the value of a periodic determination to define the need of long-term anticoagulant therapy.