tetano
Editor, Senior Moderator
PLoS One
. 2022 Jul 14;17(7):e0269466.
doi: 10.1371/journal.pone.0269466. eCollection 2022.
Antiphospholipid antibodies and vitamin D deficiency in COVID-19 infection with and without venous or arterial thrombosis: A pilot case-control study
Ruchi Shah[SUP] 1 [/SUP], Yaqub Nadeem Mohammed[SUP] 1 [/SUP], Tracy J Koehler[SUP] 2 [/SUP], Jasmeet Kaur[SUP] 1 [/SUP], Margarita Toufeili[SUP] 1 [/SUP], Priyanjali Pulipati[SUP] 1 [/SUP], Ahmed Alqaysi[SUP] 1 [/SUP], Ali Khan[SUP] 1 [/SUP], Mahrukh Khalid[SUP] 1 [/SUP], Yi Lee[SUP] 1 [/SUP], Parveen Dhillon[SUP] 3 [/SUP], Anna Thao Dan[SUP] 3 [/SUP], Nicholas Kumar[SUP] 3 [/SUP], Monica Bowen[SUP] 2 [/SUP], Anupam A Sule[SUP] 1 [/SUP], Geetha Krishnamoorthy[SUP] 1 [/SUP]
Affiliations
Abstract
Background: Coronavirus disease-2019 (COVID-19) is associated with thromboembolism. Antiphospholipid antibody (APLa) formation is one of the mechanisms. Vitamin D deficiency has been associated with thrombosis in antiphospholipid antibody syndrome.
Objective: Measure APLa and vitamin D in hospitalized COVID-19 patients with and without thrombosis to evaluate if thromboembolism is associated with concomitant APLa and vitamin D deficiency.
Methods: Case-control study. Hospitalized COVID-19 patients with a thromboembolic event (ischemic stroke, myocardial infarction, deep venous thrombosis/pulmonary embolism, Cases n = 20). Controls (n = 20): Age, sex-matched without thromboembolic events. Patients with autoimmune disorders, antiphospholipid antibody syndrome, thrombophilia, anticoagulation therapy, prior thromboembolism, chronic kidney disease 3b, 4, end-stage renal disease, and malignancy were excluded. Given the limited current literature on the role of concomitant antiphospholipid antibodies and vitamin D deficiency in causing venous and/or arterial thrombosis in hospitalized COVID-19 patients, we enrolled 20 patients in each arm. Anti-cardiolipin IgG/IgM, beta-2 glycoprotein-1 IgG/IgM, lupus anticoagulant and vitamin D levels were measured in both groups.
Results: Cases were 5.7 times more likely to be vitamin D deficient (OR:5.7, 95% CI:1.3-25.6) and 7.4 times more likely to have any one APLa (OR:7.4, 95% CI: 1.6-49.5) while accounting for the effects of sex. Patients with both APLa and vitamin D deficiency had significantly more thrombosis compared to patients who were antibody positive without vitamin D deficiency (100% vs 47.4%; p = 0.01).
Conclusions: Thrombosis in COVID-19 was associated with concomitant APLa and vitamin D deficiency. Future studies in COVID-19 should assess the role of vitamin D in reducing thrombosis.
. 2022 Jul 14;17(7):e0269466.
doi: 10.1371/journal.pone.0269466. eCollection 2022.
Antiphospholipid antibodies and vitamin D deficiency in COVID-19 infection with and without venous or arterial thrombosis: A pilot case-control study
Ruchi Shah[SUP] 1 [/SUP], Yaqub Nadeem Mohammed[SUP] 1 [/SUP], Tracy J Koehler[SUP] 2 [/SUP], Jasmeet Kaur[SUP] 1 [/SUP], Margarita Toufeili[SUP] 1 [/SUP], Priyanjali Pulipati[SUP] 1 [/SUP], Ahmed Alqaysi[SUP] 1 [/SUP], Ali Khan[SUP] 1 [/SUP], Mahrukh Khalid[SUP] 1 [/SUP], Yi Lee[SUP] 1 [/SUP], Parveen Dhillon[SUP] 3 [/SUP], Anna Thao Dan[SUP] 3 [/SUP], Nicholas Kumar[SUP] 3 [/SUP], Monica Bowen[SUP] 2 [/SUP], Anupam A Sule[SUP] 1 [/SUP], Geetha Krishnamoorthy[SUP] 1 [/SUP]
Affiliations
- PMID: 35834511
- DOI: 10.1371/journal.pone.0269466
Abstract
Background: Coronavirus disease-2019 (COVID-19) is associated with thromboembolism. Antiphospholipid antibody (APLa) formation is one of the mechanisms. Vitamin D deficiency has been associated with thrombosis in antiphospholipid antibody syndrome.
Objective: Measure APLa and vitamin D in hospitalized COVID-19 patients with and without thrombosis to evaluate if thromboembolism is associated with concomitant APLa and vitamin D deficiency.
Methods: Case-control study. Hospitalized COVID-19 patients with a thromboembolic event (ischemic stroke, myocardial infarction, deep venous thrombosis/pulmonary embolism, Cases n = 20). Controls (n = 20): Age, sex-matched without thromboembolic events. Patients with autoimmune disorders, antiphospholipid antibody syndrome, thrombophilia, anticoagulation therapy, prior thromboembolism, chronic kidney disease 3b, 4, end-stage renal disease, and malignancy were excluded. Given the limited current literature on the role of concomitant antiphospholipid antibodies and vitamin D deficiency in causing venous and/or arterial thrombosis in hospitalized COVID-19 patients, we enrolled 20 patients in each arm. Anti-cardiolipin IgG/IgM, beta-2 glycoprotein-1 IgG/IgM, lupus anticoagulant and vitamin D levels were measured in both groups.
Results: Cases were 5.7 times more likely to be vitamin D deficient (OR:5.7, 95% CI:1.3-25.6) and 7.4 times more likely to have any one APLa (OR:7.4, 95% CI: 1.6-49.5) while accounting for the effects of sex. Patients with both APLa and vitamin D deficiency had significantly more thrombosis compared to patients who were antibody positive without vitamin D deficiency (100% vs 47.4%; p = 0.01).
Conclusions: Thrombosis in COVID-19 was associated with concomitant APLa and vitamin D deficiency. Future studies in COVID-19 should assess the role of vitamin D in reducing thrombosis.