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Effects of antiphospholipid antibodies in the severity and outcome of COVID-19
Batool Zamani1, Maedeh Najafizadeh2, Atiye Jokar1
1Autoimmune Diseases Research Center, Kashan University of Medical Sciences, Kashan, Iran.
Insights
Antiphospholipid antibodies (aPL) show increased levels in severe COVID-19 cases, particularly in non-survivors. These antibody changes may serve as effective markers for predicting COVID-19 severity and patient outcomes.
Area of Science:
- Immunology
- Virology
- Pathophysiology
Background:
- A high prevalence of antiphospholipid antibodies (aPL) is noted in COVID-19 patients.
- Existing research on aPL's role in COVID-19 thrombosis and outcomes is inconsistent.
Purpose of the Study:
- To investigate antiphospholipid antibodies (aPL) as potential markers for COVID-19 development and outcomes.
- To assess the association between specific aPL types and disease severity.
Main Methods:
- Serum samples from 95 moderate and severe COVID-19 patients were analyzed.
- Prevalence of lupus anticoagulant (LA), IgM/IgG aPL, aβ2GPI, and aCL antibodies was measured using ELISA.
- Mixing tests were conducted for unexplained aPTT prolongation.
Main Results:
- Severe COVID-19 patients exhibited higher IgG aβ2GPI and IgG aPL levels.
- Increased LA prevalence was observed in severe cases with prolonged aPTT and PT.
- Higher IgM/IgG aPL, aCL, and aβ2GPI levels were found in severe patients requiring ICU admission.
- Non-survivors had significantly higher IgM aCL and IgG aPL levels compared to survivors.
Conclusions:
- Elevated antiphospholipid antibody (aPL) levels correlate with COVID-19 severity.
- Specific aPL changes can serve as effective biomarkers for predicting COVID-19 outcomes.
- Further research is warranted to elucidate the precise role of aPL in COVID-19 pathogenesis.
Objective:
A high prevalence of antiphospholipid antibodies (aPL) has been reported in patients with coronavirus disease 2019 (COVID-19). Although some studies have demonstrated roles for aPL in thrombotic events in COVID-19, findings on their association with disease development and outcomes remain heterogeneous. Therefore, this study investigated whether aPL may serve as effective markers for determining the development and outcome of COVID-19.
Methods:
Serum samples were isolated from whole blood of 95 individuals with moderate and severe COVID-19. The prevalence of lupus anticoagulant (LA), IgM/IgG antiphospholipid (aPL), IgM/IgG anti-β2-glycoprotein I (aβ2GPI), and IgM/IgG anticardiolipin (aCL) antibodies was measured by enzyme-linked immunosorbent assay. A mixing test was performed in patients with unexplained prolongation of activated partial thromboplastin time (aPTT) to distinguish coagulation factor deficiencies from factor inhibitors. The percentage of selected immune cells and values of biochemical markers were also assessed.
Results:
Patients with severe COVID-19 showed significant increases in IgG aβ2GPI and IgG aPL antibody levels compared with individuals with moderate COVID-19 (P < 0.05). The mixing test showed that LA had an increased prevalence in severe patients with unexplained prolongation of aPTT and prothrombin time (PT) (P < 0.01-0.05). No significant differences were observed in IgM/IgG aCL, IgM aPL, or IgM aβ2GPI antibody levels between severe and moderate cases. Additional findings revealed that severe COVID-19 patients who required intensive care unit (ICU) treatment had significant increases in IgM/IgG aPL, IgM/IgG aCL, and IgM/IgG aβ2GPI antibodies (P < 0.01-0.05). However, there was no significant change in the prevalence of LA or IgM aβ2GPI antibodies between severe patients who required ICU therapy and those who did not. IgM aCL and IgG aPL values were significantly higher in non-survivors compared with survivors (P < 0.001-0.05). A similar trend was observed for IgG aCL and IgM aPL levels in non-survivors, although these increases were not statistically significant.
Conclusion:
Changes in aPL levels may be considered effective markers for clarifying the severity and outcome of COVID-19.
Clinical Trial:
Not applicable.
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