剖析西班牙COVID-19患者抗磷脂抗体存在时的血栓形成事件

C. Rita
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摘要

已报道了SARS-CoV-2感染患者的几种血栓性并发症。单中心试点研究旨在分析抗磷脂抗体与SARS-CoV-2感染患者血栓形成事件的共存。采用固相酶免疫分析法测定抗磷脂抗体。临床资料从电子病历和临床记录中收集。在研究的25例患者中,我们报告了4例出现循环抗磷脂抗体和动脉或静脉血栓形成事件的COVID-19患者。患者既往无血栓病史。肺栓塞2例,肺栓塞合并肺梗死1例,脑卒中1例。抗心磷脂抗体均呈阳性。1名患者死亡,3名出院。在这些患者中出现抗磷脂抗体可能是继发于病毒免疫刺激的副现象。考虑将检测抗磷脂抗体作为COVID-19患者血栓形成事件研究的一部分是合理的,以便更好地了解这些抗体在血栓形成事件发展中的影响,我们强调定期检测的价值,以确定长期抗凝治疗的需要。
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Dissecting the Thrombotic Events in the Presence of Antiphospholipid Antibodies in COVID-19 Spanish Patients
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.
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