Lupus anticoagulant associates with thrombosis in patients with COVID-19 admitted to intensive care units: A retrospective cohort study.
COVID‐19
critically ill
lupus anticoagulant
risk factor
thrombosis
Journal
Research and practice in thrombosis and haemostasis
ISSN: 2475-0379
Titre abrégé: Res Pract Thromb Haemost
Pays: United States
ID NLM: 101703775
Informations de publication
Date de publication:
Aug 2022
Aug 2022
Historique:
received:
16
05
2022
revised:
22
08
2022
accepted:
24
08
2022
entrez:
30
9
2022
pubmed:
1
10
2022
medline:
1
10
2022
Statut:
epublish
Résumé
Thrombosis is a frequent and severe complication in patients with coronavirus disease 2019 (COVID-19) admitted to the intensive care unit (ICU). Lupus anticoagulant (LA) is a strong acquired risk factor for thrombosis in various diseases and is frequently observed in patients with COVID-19. Whether LA is associated with thrombosis in patients with severe COVID-19 is currently unclear. To investigate if LA is associated with thrombosis in critically ill patients with COVID-19. The presence of LA and other antiphospholipid antibodies was assessed in patients with COVID-19 admitted to the ICU. LA was determined with dilute Russell's viper venom time (dRVVT) and LA-sensitive activated partial thromboplastin time (aPTT) reagents. Of 169 patients with COVID-19, 116 (69%) tested positive for at least one antiphospholipid antibody upon admission to the ICU. Forty (24%) patients tested positive for LA; of whom 29 (17%) tested positive with a dRVVT, 19 (11%) tested positive with an LA-sensitive aPTT, and 8 (5%) tested positive on both tests. Fifty-eight (34%) patients developed thrombosis after ICU admission. The odds ratio (OR) for thrombosis in patients with LA based on a dRVVT was 2.5 (95% confidence interval [CI], 1.1-5.7), which increased to 4.5 (95% CI, 1.4-14.3) in patients at or below the median age in this study (64 years). LA positivity based on a dRVVT or LA-sensitive aPTT was only associated with thrombosis in patients aged less than 65 years (OR, 3.8; 95% CI, 1.3-11.4) and disappeared after adjustment for C-reactive protein. Lupus anticoagulant on admission is strongly associated with thrombosis in critically ill patients with COVID-19, especially in patients aged less than 65 years.
Sections du résumé
Background
UNASSIGNED
Thrombosis is a frequent and severe complication in patients with coronavirus disease 2019 (COVID-19) admitted to the intensive care unit (ICU). Lupus anticoagulant (LA) is a strong acquired risk factor for thrombosis in various diseases and is frequently observed in patients with COVID-19. Whether LA is associated with thrombosis in patients with severe COVID-19 is currently unclear.
Objective
UNASSIGNED
To investigate if LA is associated with thrombosis in critically ill patients with COVID-19.
Patients/Methods
UNASSIGNED
The presence of LA and other antiphospholipid antibodies was assessed in patients with COVID-19 admitted to the ICU. LA was determined with dilute Russell's viper venom time (dRVVT) and LA-sensitive activated partial thromboplastin time (aPTT) reagents.
Results
UNASSIGNED
Of 169 patients with COVID-19, 116 (69%) tested positive for at least one antiphospholipid antibody upon admission to the ICU. Forty (24%) patients tested positive for LA; of whom 29 (17%) tested positive with a dRVVT, 19 (11%) tested positive with an LA-sensitive aPTT, and 8 (5%) tested positive on both tests. Fifty-eight (34%) patients developed thrombosis after ICU admission. The odds ratio (OR) for thrombosis in patients with LA based on a dRVVT was 2.5 (95% confidence interval [CI], 1.1-5.7), which increased to 4.5 (95% CI, 1.4-14.3) in patients at or below the median age in this study (64 years). LA positivity based on a dRVVT or LA-sensitive aPTT was only associated with thrombosis in patients aged less than 65 years (OR, 3.8; 95% CI, 1.3-11.4) and disappeared after adjustment for C-reactive protein.
Conclusion
UNASSIGNED
Lupus anticoagulant on admission is strongly associated with thrombosis in critically ill patients with COVID-19, especially in patients aged less than 65 years.
Identifiants
pubmed: 36178455
doi: 10.1002/rth2.12809
pii: S2475-0379(22)02363-9
pmc: PMC9481876
doi:
Types de publication
Journal Article
Langues
eng
Pagination
e12809Investigateurs
D van de Beek
(D)
M C Brouwer
(MC)
S de Bruin
(S)
M Coppens
(M)
N van Es
(N)
T F van Haaps
(TF)
N P Juffermans
(NP)
M C A Muller
(MCA)
A P J Vlaar
(APJ)
C M P M Hertogh
(CMPM)
L M A Heunks
(LMA)
J G Hugtenburg
(JG)
J van Kooten
(J)
E J Nossent
(EJ)
Y Smulders
(Y)
P R Tuinman
(PR)
A Vonk Noordegraaf
(A)
M J J H Grootenboers
(MJJH)
C van Guldener
(C)
M Kant
(M)
A Lansbergen
(A)
J Faber
(J)
G Hajer
(G)
A Stemerdink
(A)
J van den Akker
(J)
R Bierings
(R)
H Endeman
(H)
M Goeijenbier
(M)
N G M Hunfeld
(NGM)
E C M van Gorp
(ECM)
D A M P J Gommers
(DAMPJ)
M P G Koopmans
(MPG)
M J H A Kruip
(MJHA)
T Kuiken
(T)
T Langerak
(T)
None Leebeek
M N Lauw
(MN)
M P M de Maat
(MPM)
D Noack
(D)
M S Paats
(MS)
M P Raadsen
(MP)
B Rockx
(B)
C Rokx
(C)
C A M Schurink
(CAM)
K Tong-Minh
(K)
L van den Toorn
(L)
C A den Uil
(CA)
C Visser
(C)
F Boutkourt
(F)
T Roest
(T)
R A Douma
(RA)
L R de Haan
(LR)
M Ten Wolde
(M)
R H H Bemelmans
(RHH)
B Festen
(B)
S Stads
(S)
C P C de Jager
(CPC)
K S Simons
(KS)
M L Antoni
(ML)
M H Bos
(MH)
J L I Burggraaf
(JLI)
S C Cannegieter
(SC)
H C J Eikenboom
(HCJ)
P L den Exter
(PL)
J J M Geelhoed
(JJM)
M V Huisman
(MV)
E de Jonge
(E)
F H J Kaptein
(FHJ)
F A Klok
(FA)
L J M Kroft
(LJM)
W M Lijfering
(WM)
L Nab
(L)
M K Ninaber
(MK)
H Putter
(H)
S R S Ramai
(SRS)
A M da Rocha Rondon
(AM)
A H E Roukens
(AHE)
M A M Stals
(MAM)
H H Versteeg
(HH)
H W Vliegen
(HW)
B J M van Vlijmen
(BJM)
T van de Berg
(T)
R Bruggemann
(R)
B C T van Bussel
(BCT)
H Ten Cate
(H)
A Ten Cate-Hoek
(A)
T M Hackeng
(TM)
Ir Y Henskens
(IY)
A Hulshof
(A)
M Mulder
(M)
R H Olie
(RH)
L Schurgers
(L)
B Spaetgens
(B)
H Spronk
(H)
K Winckers
(K)
L Nieuwenhuizen
(L)
B Franken
(B)
I M Schrover
(IM)
E G M de Waal
(EGM)
A Beishuizen
(A)
A Cornet
(A)
J Krabbe
(J)
K Kramers
(K)
J Leentjens
(J)
Q de Mast
(Q)
S Middeldorp
(S)
R E Brouwer
(RE)
J L J Ellerbroek
(JLJ)
J Tijmensen
(J)
M M C Hovens
(MMC)
E A N Oostdijk
(EAN)
B D Westerhof
(BD)
L M Faber
(LM)
M van den Biggelaar
(M)
J C M Meijers
(JCM)
J Voorberg
(J)
M E Kevenaar
(ME)
Y L Soei
(YL)
E J Wils
(EJ)
F N Croles
(FN)
B de Laat
(B)
P W Kamphuisen
(PW)
R Vink
(R)
T Lisman
(T)
K Meijer
(K)
Y I G van Tichelaar
(YIG)
O L Cremer
(OL)
G Geersing
(G)
H A H Kaasjager
(HAH)
N Kusadasi
(N)
A Huisman
(A)
C Maas
(C)
M Nijkeuter
(M)
R E G Schutgens
(REG)
Van Creveldkliniek
(V)
R T Urbanus
(RT)
Van Creveldkliniek
(V)
J Westerink
(J)
H J Faber
(HJ)
S C E Koster
(SCE)
P van Montfort
(P)
D J L van Twist
(DJL)
Commentaires et corrections
Type : ErratumIn
Informations de copyright
© 2022 The Authors. Research and Practice in Thrombosis and Haemostasis published by Wiley Periodicals LLC on behalf of International Society on Thrombosis and Haemostasis (ISTH).
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