tetano
Editor, Senior Moderator
Lupus
. 2021 Dec 16;9612033211062523.
doi: 10.1177/09612033211062523. Online ahead of print.
COVID-19 and antiphospholipid antibodies: A position statement and management guidance from AntiPhospholipid Syndrome Alliance for Clinical Trials and InternatiOnal Networking (APS ACTION)
Xin Wang[SUP] 1 [/SUP], Elena Gkrouzman[SUP] 2 [/SUP], Danieli Castro Oliveira Andrade[SUP] 3 [/SUP], Laura Andreoli[SUP] 4 [/SUP], Medha Barbhaiya[SUP] 5 [/SUP], H Michael Belmont[SUP] 6 [/SUP], David Ware Branch[SUP] 7 [/SUP], Guilherme R de Jesús[SUP] 8 [/SUP], Maria Efthymiou[SUP] 9 [/SUP], Roberto Ríos-Garcés[SUP] 10 [/SUP], Maria Gerosa[SUP] 11 [/SUP], Georges El Hasbani[SUP] 12 [/SUP], Jason Knight[SUP] 13 [/SUP], Pier Luigi Meroni[SUP] 11 [/SUP], Giulia Pazzola[SUP] 14 [/SUP], Michelle Petri[SUP] 15 [/SUP], Jacob Rand[SUP] 16 [/SUP], Jane Salmon[SUP] 17 [/SUP], Maria Tektonidou[SUP] 18 [/SUP], Angela Tincani[SUP] 4 [/SUP], Imad W Uthman[SUP] 12 [/SUP], Stephane Zuily[SUP] 19 [/SUP], Yu Zuo[SUP] 13 [/SUP], Michael Lockshin[SUP] 5 [/SUP], Hannah Cohen[SUP] 9 [/SUP], Doruk Erkan[SUP] 5 [/SUP], APS ACTION
Affiliations
Abstract
Coronavirus disease 2019 (COVID-19) is associated with a high rate of thrombosis. Prolonged activated partial thromboplastin times (aPTT) and antiphospholipid antibodies (aPL) are reported in COVID-19 patients. The majority of publications have not reported whether patients develop clinically relevant persistent aPL, and the clinical significance of new aPL-positivity in COVID-19 is currently unknown. However, the reports of aPL-positivity in COVID-19 raised the question whether common mechanisms exist in the pathogenesis of COVID-19 and antiphospholipid syndrome (APS). In both conditions, thrombotic microangiopathy resulting in microvascular injury and thrombosis is hypothesized to occur through multiple pathways, including endothelial damage, complement activation, and release of neutrophil extracellular traps (NETosis). APS-ACTION, an international APS research network, created a COVID-19 working group that reviewed common mechanisms, positive aPL tests in COVID-19 patients, and implications of COVID-19 infection for patients with known aPL positivity or APS, with the goals of proposing guidance for clinical management and monitoring of aPL-positive COVID-19 patients. This guidance also serves as a call and focus for clinical and basic scientific research.
Keywords: Antiphospholipid antibodies; COVID-19; Hughes syndrome; anticoagulation; antiphospholipid syndrome; lupus anticoagulant; thrombosis.
. 2021 Dec 16;9612033211062523.
doi: 10.1177/09612033211062523. Online ahead of print.
COVID-19 and antiphospholipid antibodies: A position statement and management guidance from AntiPhospholipid Syndrome Alliance for Clinical Trials and InternatiOnal Networking (APS ACTION)
Xin Wang[SUP] 1 [/SUP], Elena Gkrouzman[SUP] 2 [/SUP], Danieli Castro Oliveira Andrade[SUP] 3 [/SUP], Laura Andreoli[SUP] 4 [/SUP], Medha Barbhaiya[SUP] 5 [/SUP], H Michael Belmont[SUP] 6 [/SUP], David Ware Branch[SUP] 7 [/SUP], Guilherme R de Jesús[SUP] 8 [/SUP], Maria Efthymiou[SUP] 9 [/SUP], Roberto Ríos-Garcés[SUP] 10 [/SUP], Maria Gerosa[SUP] 11 [/SUP], Georges El Hasbani[SUP] 12 [/SUP], Jason Knight[SUP] 13 [/SUP], Pier Luigi Meroni[SUP] 11 [/SUP], Giulia Pazzola[SUP] 14 [/SUP], Michelle Petri[SUP] 15 [/SUP], Jacob Rand[SUP] 16 [/SUP], Jane Salmon[SUP] 17 [/SUP], Maria Tektonidou[SUP] 18 [/SUP], Angela Tincani[SUP] 4 [/SUP], Imad W Uthman[SUP] 12 [/SUP], Stephane Zuily[SUP] 19 [/SUP], Yu Zuo[SUP] 13 [/SUP], Michael Lockshin[SUP] 5 [/SUP], Hannah Cohen[SUP] 9 [/SUP], Doruk Erkan[SUP] 5 [/SUP], APS ACTION
Affiliations
- PMID: 34915764
- DOI: 10.1177/09612033211062523
Abstract
Coronavirus disease 2019 (COVID-19) is associated with a high rate of thrombosis. Prolonged activated partial thromboplastin times (aPTT) and antiphospholipid antibodies (aPL) are reported in COVID-19 patients. The majority of publications have not reported whether patients develop clinically relevant persistent aPL, and the clinical significance of new aPL-positivity in COVID-19 is currently unknown. However, the reports of aPL-positivity in COVID-19 raised the question whether common mechanisms exist in the pathogenesis of COVID-19 and antiphospholipid syndrome (APS). In both conditions, thrombotic microangiopathy resulting in microvascular injury and thrombosis is hypothesized to occur through multiple pathways, including endothelial damage, complement activation, and release of neutrophil extracellular traps (NETosis). APS-ACTION, an international APS research network, created a COVID-19 working group that reviewed common mechanisms, positive aPL tests in COVID-19 patients, and implications of COVID-19 infection for patients with known aPL positivity or APS, with the goals of proposing guidance for clinical management and monitoring of aPL-positive COVID-19 patients. This guidance also serves as a call and focus for clinical and basic scientific research.
Keywords: Antiphospholipid antibodies; COVID-19; Hughes syndrome; anticoagulation; antiphospholipid syndrome; lupus anticoagulant; thrombosis.