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Are antiphospholipid antibodies just a common epiphenomenon or are they causative of immune-mediated coagulopathy in COVID-19?
- Source :
- Clinical Rheumatology
- Publication Year :
- 2021
- Publisher :
- Springer Science and Business Media LLC, 2021.
-
Abstract
- The coronavirus disease 2019 (COVID-19) is the largest public health emergency in recent times. A significant number of patients develop a severe form of COVID-19 characterized by coagulopathy, organ failure, and elevated mortality. In addition, an unusually high frequency of antiphospholipid antibodies (aPLs) has been found in patients with COVID-19. These clinical and serological manifestations closely resemble those seen in the antiphospholipid syndrome (APS), especially in its catastrophic form, suggesting a role of aPLs in immune-associated coagulopathy. However, government bodies such as the American Society of Hematology have spoken out against the systematic search for aPLs in patients with COVID-19. In an attempt to bridge the gap on this hot topic, we conducted a comprehensive review of currently available cohort studies and case series systematically evaluating aPLs in COVID-19 patients. In this Perspective, we seek to identify both the frequency and the type of aPLs found in patients with COVID-19, as well as the potential association of these aPLs with vascular thrombosis and other distinctive characteristics of COVID-19. Furthermore, we investigated whether there is evidence that allows us to define the occurrence of aPLs in COVID-19 as an epiphenomenon, as has been observed in other systemic viral infections, or as antibodies against self-antigens bearing hallmarks that suggest a pathogenic role in immune-mediated thrombosis. Defining whether aPLs represent an epiphenomenon or they are actually involved in hemostatic abnormalities of COVID-19 is crucial both for uncovering novel mechanisms of immune-mediated thrombosis and for identifying potential prognostic biomarkers in this devastating disease.
- Subjects :
- medicine.medical_specialty
Epiphenomenon
Disease
Serology
03 medical and health sciences
0302 clinical medicine
Rheumatology
immune system diseases
Antiphospholipid syndrome
Internal medicine
medicine
Coagulopathy
Humans
030212 general & internal medicine
neoplasms
Inflammation
030203 arthritis & rheumatology
Hematology
SARS-CoV-2
business.industry
Antiphospholipid antibodies
COVID-19
Thrombosis
General Medicine
Antiphospholipid Syndrome
medicine.disease
Immunology
Antibodies, Antiphospholipid
business
Perspectives in Rheumatology
Subjects
Details
- ISSN :
- 14349949 and 07703198
- Volume :
- 40
- Database :
- OpenAIRE
- Journal :
- Clinical Rheumatology
- Accession number :
- edsair.doi.dedup.....fd3c50aa6fa1a6e02f78989d1dd2fc51