Title

COVID-19 and antiphospholipid antibodies: A position statement and management guidance from AntiPhospholipid Syndrome Alliance for Clinical Trials and InternatiOnal Networking (APS ACTION)

UMMS Affiliation

Department of Medicine, Division of Rheumatology

Publication Date

2021-12-16

Document Type

Article

Disciplines

Immune System Diseases | Immunology and Infectious Disease | Infectious Disease | Microbiology | Skin and Connective Tissue Diseases | Virus Diseases

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

DOI of Published Version

10.1177/09612033211062523

Source

Wang X, Gkrouzman E, Andrade DCO, Andreoli L, Barbhaiya M, Belmont HM, Branch DW, de Jesús GR, Efthymiou M, Ríos-Garcés R, Gerosa M, El Hasbani G, Knight J, Meroni PL, Pazzola G, Petri M, Rand J, Salmon J, Tektonidou M, Tincani A, Uthman IW, Zuily S, Zuo Y, Lockshin M, Cohen H, Erkan D; APS ACTION. COVID-19 and antiphospholipid antibodies: A position statement and management guidance from AntiPhospholipid Syndrome Alliance for Clinical Trials and InternatiOnal Networking (APS ACTION). Lupus. 2021 Dec;30(14):2276-2285. doi: 10.1177/09612033211062523. Epub 2021 Dec 16. PMID: 34915764. Link to article on publisher's site

Journal/Book/Conference Title

Lupus

Comments

Full author list omitted for brevity. For the full list of authors, see article.

Related Resources

Link to Article in PubMed

PubMed ID

34915764

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