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Lupus anticoagulant associates with thrombosis in patients with COVID‐19 admitted to intensive care units: A retrospective cohort study

2022; Elsevier BV; Volume: 6; Issue: 6 Linguagem: Inglês

10.1002/rth2.12809

2475-0379

Tessa Noordermeer, Roger E. G. Schutgens, Chantal Visser, Emma Rademaker, Moniek P.M. de Maat, A.J. Gerard Jansen, Maarten Limper, Olaf L. Cremer, Marieke J. H. A. Kruip, Henrik Endeman, Coen Maas, Bas de Laat, Rolf T. Urbanus, Diederik van de Beek, Matthijs C. Brouwer, Sanne de Bruin, Michiel Coppens, Nick van Es, T.F. van Haaps, Nicole P. Juffermans, Mogens Müller, Alexander P. J. Vlaar, Cees M.P.M. Hertogh, Leo Heunks, Jacqueline G. Hugtenburg, Janine van Kooten, Esther J. Nossent, Yvo M. Smulders, P.R. Tuinman, Anton Vonk Noordegraaf, Marco J.J.H. Grootenboers, Coen van Guldener, Matthias Kant, A. Lansbergen, Joyce Faber, G.F. Hajer, A. Stemerdink, Jeroen van den Akker, Ruben Bierings, Henrik Endeman, Marco Goeijenbier, Nicole Hunfeld, Eric C. M. Van Gorp, Diederik Gommers, Marion Koopmans, Marieke J.H.A. Kruip, Todd Kuiken, Thomas Langerak, Leebeek, Mandy N. Lauw, Moniek P.M. de Maat, Danny Noack, Marthe S. Paats, Matthijs P. Raadsen, Barry Rockx, Casper Rokx, Carolina A. M. Schurink, Kirby Tong‐Minh, Leon van den Toorn, Corstiaan A. den Uil, Chantal Visser, Firdaouss Boutkourt, Thirza J. Roest, Renée A. Douma, Lianne R. de Haan, M. ten Wolde, Remy H.H. Bemelmans, Barbara Festen, Susanne Stads, Cornelis P. C. de Jager, Koen S. Simons, M. Louisa Antoni, Mettine H.A. Bos, J. Burggraaf, Suzanne C. Cannegieter, Jeroen Eikenboom, P.L. den Exter, J.J. Miranda Geelhoed, M.V. Huisman, Evert de Jonge, Fleur H.J. Kaptein, Frederikus A. Klok, Lucia J.M. Kroft, Willem M. Lijfering, Linda Nab, M.K. Ninaber, Hein Putter, S.R.S. Ramai, Andres Rondon, Anna H.E. Roukens, Milou A.M. Stals, Henri H. Versteeg, Hubert W. Vliegen, B.J.M. van Vlijmen, Tove Berg, Rainer Brüggemann, Bas C. T. van Bussel, Hugo Ten Cate, Arina J. ten Cate‐Hoek, Tilman M. Hackeng, ir.Y. Henskens, Anne‐Marije Hulshof, M. Mulder, Renske H. Olie, Leon J. Schurgers, Bart Spaetgens, Henri M.H. Spronk, Kristien Winckers, L. Nieuwenhuizen, Bas Franken, Ilse M. Schrover, Esther G.M. De Waal, Albertus Beishuizen, Alexander D. Cornet, Johannes G. Krabbe, Kees Kramers, Jenneke Leentjens, Quirijn de Mast, S. Middeldorp, Rolf E. Brouwer, Jacobien Ellerbroek, Janneke Tijmensen, M. Hovens, Evelien Oostdijk, Brigitte Westerhof, Laura M. Faber, Maartje van den Biggelaar, Joost C.M. Meijers, Jan Voorberg, M.E. Kevenaar, Y.L. Soei, Evert‐Jan Wils, F. Nanne Croles, Bas de Laat, Pieter W. Kamphuisen, Robert Vink, Ton Lisman, K. A. Meijer, Y.I.G. van Tichelaar, Olaf L. Cremer, Geert‐Jan Geersing, H. A. H. Kaasjager, Nuray Kuşadasi, A. Huisman, Coen Maas, Mathilde Nijkeuter, Roger E. G. Schutgens, Van Creveldkliniek, Rolf T. Urbanus, Van Creveldkliniek, Jan Westerink, Harald J. Faber, Stephanie C. E. Koster, Pim van Montfort, Daan J.L. van Twist,

Dermatological and COVID-19 studies

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.