Lupus anticoagulant single positivity at acute phase is not associated with venous thromboembolism or in-hospital mortality in COVID-19
Antiphospholipid antibodies (APA) clinical relevance in COVID-19 is controversial. We aimed to investigate the prevalence and prognostic value of conventional and non-conventional APA in COVID-19 patients. This study was a multi-centric, prospective observational French cohort of patients hospitaliz...
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| creator | Gendron, Nicolas Dragon-Durey, Marie-Agnès Chocron, Richard Darnige, Luc Jourdi, Georges Philippe, Aurélien Chenevier-Gobeaux, Camille Hadjadj, Jérôme Duchemin, Jérôme Khider, Lina Yatim, Nader Goudot, Guillaume Krzisch, Daphné Debuc, Benjamin Mauge, Laetitia Levasseur, Françoise Pene, Frédéric Boussier, Jeremy Sourdeau, Elise Brichet, Julie Ochat, Nadège Goulvestre, Claire Peronino, Christophe Szwebel, Tali-Anne Pages, Franck Gaussem, Pascale Samama, Charles-Marc Cheurfa, Cherifa Planquette, Benjamin Sanchez, Olivier Diehl, Jean-Luc Mirault, Tristan Fontenay, Michaela Terrier, Benjamin Smadja, David M |
| description | Antiphospholipid antibodies (APA) clinical relevance in COVID-19 is controversial. We aimed to investigate the prevalence and prognostic value of conventional and non-conventional APA in COVID-19 patients.
This study was a multi-centric, prospective observational French cohort of patients hospitalized for COVID-19 suspicion.
249 patients were hospitalized for suspected COVID-19, including 154 with confirmed COVID-19 and 95 not confirmed. We found a significant increase in lupus anticoagulant (LA) positivity among COVID-19 positive patients (60.9% versus 23.7% in non-COVID19 patients, p |
| doi_str_mv | 10.1002/art.41777 |
| format | Article |
| fullrecord | <record><control><sourceid>pubmed</sourceid><recordid>TN_cdi_pubmed_primary_33881229</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>33881229</sourcerecordid><originalsourceid>FETCH-LOGICAL-p519-94b949929a7c3b5e4dc131f04de30dd6790902624203d6867c9ba34c89f2d12c3</originalsourceid><addsrcrecordid>eNo1kEtqwzAYhEWhNCHNohcouoBTvWxZy5K-AoZsQrdBluT4L7ZlLDklJ-i1q9J2YJhhFt9iELqjZEMJYQ96ihtBpZRXaMk4K7KckXyB1iF8kCQlSUHyG7TgvCwpY2qJvqp5nAPWQwTj9WnuUsMBhlPn8OgDRDhDvGAdsTZzTFurg8MQ8ODTFII3oKOz-BNii89u8AkW28n3tXfJHYQe-wnDkLU-jBB1h3s_pfihwoC3-_fdU0bVLbpudBfc-i9X6PDyfNi-ZdX-dbd9rLIxpypTolZCKaa0NLzOnbCGctoQYR0n1hZSEUVYwQQj3BZlIY2qNRemVA2zlBm-Qve_2HGue2eP4wS9ni7H_0P4N58tYn4</addsrcrecordid><sourcetype>Index Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype></control><display><type>article</type><title>Lupus anticoagulant single positivity at acute phase is not associated with venous thromboembolism or in-hospital mortality in COVID-19</title><source>Wiley Online Library Journals Frontfile Complete</source><source>Alma/SFX Local Collection</source><creator>Gendron, Nicolas ; Dragon-Durey, Marie-Agnès ; Chocron, Richard ; Darnige, Luc ; Jourdi, Georges ; Philippe, Aurélien ; Chenevier-Gobeaux, Camille ; Hadjadj, Jérôme ; Duchemin, Jérôme ; Khider, Lina ; Yatim, Nader ; Goudot, Guillaume ; Krzisch, Daphné ; Debuc, Benjamin ; Mauge, Laetitia ; Levasseur, Françoise ; Pene, Frédéric ; Boussier, Jeremy ; Sourdeau, Elise ; Brichet, Julie ; Ochat, Nadège ; Goulvestre, Claire ; Peronino, Christophe ; Szwebel, Tali-Anne ; Pages, Franck ; Gaussem, Pascale ; Samama, Charles-Marc ; Cheurfa, Cherifa ; Planquette, Benjamin ; Sanchez, Olivier ; Diehl, Jean-Luc ; Mirault, Tristan ; Fontenay, Michaela ; Terrier, Benjamin ; Smadja, David M</creator><creatorcontrib>Gendron, Nicolas ; Dragon-Durey, Marie-Agnès ; Chocron, Richard ; Darnige, Luc ; Jourdi, Georges ; Philippe, Aurélien ; Chenevier-Gobeaux, Camille ; Hadjadj, Jérôme ; Duchemin, Jérôme ; Khider, Lina ; Yatim, Nader ; Goudot, Guillaume ; Krzisch, Daphné ; Debuc, Benjamin ; Mauge, Laetitia ; Levasseur, Françoise ; Pene, Frédéric ; Boussier, Jeremy ; Sourdeau, Elise ; Brichet, Julie ; Ochat, Nadège ; Goulvestre, Claire ; Peronino, Christophe ; Szwebel, Tali-Anne ; Pages, Franck ; Gaussem, Pascale ; Samama, Charles-Marc ; Cheurfa, Cherifa ; Planquette, Benjamin ; Sanchez, Olivier ; Diehl, Jean-Luc ; Mirault, Tristan ; Fontenay, Michaela ; Terrier, Benjamin ; Smadja, David M</creatorcontrib><description>Antiphospholipid antibodies (APA) clinical relevance in COVID-19 is controversial. We aimed to investigate the prevalence and prognostic value of conventional and non-conventional APA in COVID-19 patients.
This study was a multi-centric, prospective observational French cohort of patients hospitalized for COVID-19 suspicion.
249 patients were hospitalized for suspected COVID-19, including 154 with confirmed COVID-19 and 95 not confirmed. We found a significant increase in lupus anticoagulant (LA) positivity among COVID-19 positive patients (60.9% versus 23.7% in non-COVID19 patients, p<0.001), while prevalence of conventional (anti-cardiolipin and anti-beta-2-GP1, IgG and IgM isotypes) and non-conventional APA (IgA, anti-phosphatidylserine/prothrombin and anti-prothrombin IgG and IgM) were low in both groups. COVID-19 patients with LA positivity had higher levels of fibrinogen (6.0 IQR 5.0-7.0 versus 5.3 g/L IQR 4.3-6.4, p=0.028) and C-reactive protein (CRP, 115.5 IQR 66.0-204.8 versus 91.8 mg/L IQR 27.0-155.1, p=0.019). Univariate analysis did not show any association between LA positivity and higher risk of venous thromboembolism (VTE, OR 1.02, 95% CI 0.44-2.43, p=0.95) or in-hospital mortality (OR 1.80, 95% CI 0.70-5.05, p=0.24). Unadjusted and adjusted (to CRP, age and sex) Kaplan-Meier survival curves according to LA positivity confirmed the absence of association with VTE or in-hospital mortality (unadjusted: p=0.64 and p=0.26, respectively; adjusted: hazard ratio = 1.13 95% CI 0.48-2.60 and 1.80 95% CI 0.67-5.01).
COVID-19 patients have an increased prevalence of LA positivity associated with biological inflammation markers. However, positive LA at admission is not associated with VTE risk and/or in-hospital mortality.</description><identifier>EISSN: 2326-5205</identifier><identifier>DOI: 10.1002/art.41777</identifier><identifier>PMID: 33881229</identifier><language>eng</language><publisher>United States</publisher><ispartof>Arthritis & rheumatology (Hoboken, N.J.), 2021-04</ispartof><rights>This article is protected by copyright. All rights reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><orcidid>0000-0001-6612-7336 ; 0000-0003-4852-4738</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,777,781,27905,27906</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/33881229$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Gendron, Nicolas</creatorcontrib><creatorcontrib>Dragon-Durey, Marie-Agnès</creatorcontrib><creatorcontrib>Chocron, Richard</creatorcontrib><creatorcontrib>Darnige, Luc</creatorcontrib><creatorcontrib>Jourdi, Georges</creatorcontrib><creatorcontrib>Philippe, Aurélien</creatorcontrib><creatorcontrib>Chenevier-Gobeaux, Camille</creatorcontrib><creatorcontrib>Hadjadj, Jérôme</creatorcontrib><creatorcontrib>Duchemin, Jérôme</creatorcontrib><creatorcontrib>Khider, Lina</creatorcontrib><creatorcontrib>Yatim, Nader</creatorcontrib><creatorcontrib>Goudot, Guillaume</creatorcontrib><creatorcontrib>Krzisch, Daphné</creatorcontrib><creatorcontrib>Debuc, Benjamin</creatorcontrib><creatorcontrib>Mauge, Laetitia</creatorcontrib><creatorcontrib>Levasseur, Françoise</creatorcontrib><creatorcontrib>Pene, Frédéric</creatorcontrib><creatorcontrib>Boussier, Jeremy</creatorcontrib><creatorcontrib>Sourdeau, Elise</creatorcontrib><creatorcontrib>Brichet, Julie</creatorcontrib><creatorcontrib>Ochat, Nadège</creatorcontrib><creatorcontrib>Goulvestre, Claire</creatorcontrib><creatorcontrib>Peronino, Christophe</creatorcontrib><creatorcontrib>Szwebel, Tali-Anne</creatorcontrib><creatorcontrib>Pages, Franck</creatorcontrib><creatorcontrib>Gaussem, Pascale</creatorcontrib><creatorcontrib>Samama, Charles-Marc</creatorcontrib><creatorcontrib>Cheurfa, Cherifa</creatorcontrib><creatorcontrib>Planquette, Benjamin</creatorcontrib><creatorcontrib>Sanchez, Olivier</creatorcontrib><creatorcontrib>Diehl, Jean-Luc</creatorcontrib><creatorcontrib>Mirault, Tristan</creatorcontrib><creatorcontrib>Fontenay, Michaela</creatorcontrib><creatorcontrib>Terrier, Benjamin</creatorcontrib><creatorcontrib>Smadja, David M</creatorcontrib><title>Lupus anticoagulant single positivity at acute phase is not associated with venous thromboembolism or in-hospital mortality in COVID-19</title><title>Arthritis & rheumatology (Hoboken, N.J.)</title><addtitle>Arthritis Rheumatol</addtitle><description>Antiphospholipid antibodies (APA) clinical relevance in COVID-19 is controversial. We aimed to investigate the prevalence and prognostic value of conventional and non-conventional APA in COVID-19 patients.
This study was a multi-centric, prospective observational French cohort of patients hospitalized for COVID-19 suspicion.
249 patients were hospitalized for suspected COVID-19, including 154 with confirmed COVID-19 and 95 not confirmed. We found a significant increase in lupus anticoagulant (LA) positivity among COVID-19 positive patients (60.9% versus 23.7% in non-COVID19 patients, p<0.001), while prevalence of conventional (anti-cardiolipin and anti-beta-2-GP1, IgG and IgM isotypes) and non-conventional APA (IgA, anti-phosphatidylserine/prothrombin and anti-prothrombin IgG and IgM) were low in both groups. COVID-19 patients with LA positivity had higher levels of fibrinogen (6.0 IQR 5.0-7.0 versus 5.3 g/L IQR 4.3-6.4, p=0.028) and C-reactive protein (CRP, 115.5 IQR 66.0-204.8 versus 91.8 mg/L IQR 27.0-155.1, p=0.019). Univariate analysis did not show any association between LA positivity and higher risk of venous thromboembolism (VTE, OR 1.02, 95% CI 0.44-2.43, p=0.95) or in-hospital mortality (OR 1.80, 95% CI 0.70-5.05, p=0.24). Unadjusted and adjusted (to CRP, age and sex) Kaplan-Meier survival curves according to LA positivity confirmed the absence of association with VTE or in-hospital mortality (unadjusted: p=0.64 and p=0.26, respectively; adjusted: hazard ratio = 1.13 95% CI 0.48-2.60 and 1.80 95% CI 0.67-5.01).
COVID-19 patients have an increased prevalence of LA positivity associated with biological inflammation markers. However, positive LA at admission is not associated with VTE risk and/or in-hospital mortality.</description><issn>2326-5205</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2021</creationdate><recordtype>article</recordtype><recordid>eNo1kEtqwzAYhEWhNCHNohcouoBTvWxZy5K-AoZsQrdBluT4L7ZlLDklJ-i1q9J2YJhhFt9iELqjZEMJYQ96ihtBpZRXaMk4K7KckXyB1iF8kCQlSUHyG7TgvCwpY2qJvqp5nAPWQwTj9WnuUsMBhlPn8OgDRDhDvGAdsTZzTFurg8MQ8ODTFII3oKOz-BNii89u8AkW28n3tXfJHYQe-wnDkLU-jBB1h3s_pfihwoC3-_fdU0bVLbpudBfc-i9X6PDyfNi-ZdX-dbd9rLIxpypTolZCKaa0NLzOnbCGctoQYR0n1hZSEUVYwQQj3BZlIY2qNRemVA2zlBm-Qve_2HGue2eP4wS9ni7H_0P4N58tYn4</recordid><startdate>20210421</startdate><enddate>20210421</enddate><creator>Gendron, Nicolas</creator><creator>Dragon-Durey, Marie-Agnès</creator><creator>Chocron, Richard</creator><creator>Darnige, Luc</creator><creator>Jourdi, Georges</creator><creator>Philippe, Aurélien</creator><creator>Chenevier-Gobeaux, Camille</creator><creator>Hadjadj, Jérôme</creator><creator>Duchemin, Jérôme</creator><creator>Khider, Lina</creator><creator>Yatim, Nader</creator><creator>Goudot, Guillaume</creator><creator>Krzisch, Daphné</creator><creator>Debuc, Benjamin</creator><creator>Mauge, Laetitia</creator><creator>Levasseur, Françoise</creator><creator>Pene, Frédéric</creator><creator>Boussier, Jeremy</creator><creator>Sourdeau, Elise</creator><creator>Brichet, Julie</creator><creator>Ochat, Nadège</creator><creator>Goulvestre, Claire</creator><creator>Peronino, Christophe</creator><creator>Szwebel, Tali-Anne</creator><creator>Pages, Franck</creator><creator>Gaussem, Pascale</creator><creator>Samama, Charles-Marc</creator><creator>Cheurfa, Cherifa</creator><creator>Planquette, Benjamin</creator><creator>Sanchez, Olivier</creator><creator>Diehl, Jean-Luc</creator><creator>Mirault, Tristan</creator><creator>Fontenay, Michaela</creator><creator>Terrier, Benjamin</creator><creator>Smadja, David M</creator><scope>NPM</scope><orcidid>https://orcid.org/0000-0001-6612-7336</orcidid><orcidid>https://orcid.org/0000-0003-4852-4738</orcidid></search><sort><creationdate>20210421</creationdate><title>Lupus anticoagulant single positivity at acute phase is not associated with venous thromboembolism or in-hospital mortality in COVID-19</title><author>Gendron, Nicolas ; Dragon-Durey, Marie-Agnès ; Chocron, Richard ; Darnige, Luc ; Jourdi, Georges ; Philippe, Aurélien ; Chenevier-Gobeaux, Camille ; Hadjadj, Jérôme ; Duchemin, Jérôme ; Khider, Lina ; Yatim, Nader ; Goudot, Guillaume ; Krzisch, Daphné ; Debuc, Benjamin ; Mauge, Laetitia ; Levasseur, Françoise ; Pene, Frédéric ; Boussier, Jeremy ; Sourdeau, Elise ; Brichet, Julie ; Ochat, Nadège ; Goulvestre, Claire ; Peronino, Christophe ; Szwebel, Tali-Anne ; Pages, Franck ; Gaussem, Pascale ; Samama, Charles-Marc ; Cheurfa, Cherifa ; Planquette, Benjamin ; Sanchez, Olivier ; Diehl, Jean-Luc ; Mirault, Tristan ; Fontenay, Michaela ; Terrier, Benjamin ; Smadja, David M</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-p519-94b949929a7c3b5e4dc131f04de30dd6790902624203d6867c9ba34c89f2d12c3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2021</creationdate><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Gendron, Nicolas</creatorcontrib><creatorcontrib>Dragon-Durey, Marie-Agnès</creatorcontrib><creatorcontrib>Chocron, Richard</creatorcontrib><creatorcontrib>Darnige, Luc</creatorcontrib><creatorcontrib>Jourdi, Georges</creatorcontrib><creatorcontrib>Philippe, Aurélien</creatorcontrib><creatorcontrib>Chenevier-Gobeaux, Camille</creatorcontrib><creatorcontrib>Hadjadj, Jérôme</creatorcontrib><creatorcontrib>Duchemin, Jérôme</creatorcontrib><creatorcontrib>Khider, Lina</creatorcontrib><creatorcontrib>Yatim, Nader</creatorcontrib><creatorcontrib>Goudot, Guillaume</creatorcontrib><creatorcontrib>Krzisch, Daphné</creatorcontrib><creatorcontrib>Debuc, Benjamin</creatorcontrib><creatorcontrib>Mauge, Laetitia</creatorcontrib><creatorcontrib>Levasseur, Françoise</creatorcontrib><creatorcontrib>Pene, Frédéric</creatorcontrib><creatorcontrib>Boussier, Jeremy</creatorcontrib><creatorcontrib>Sourdeau, Elise</creatorcontrib><creatorcontrib>Brichet, Julie</creatorcontrib><creatorcontrib>Ochat, Nadège</creatorcontrib><creatorcontrib>Goulvestre, Claire</creatorcontrib><creatorcontrib>Peronino, Christophe</creatorcontrib><creatorcontrib>Szwebel, Tali-Anne</creatorcontrib><creatorcontrib>Pages, Franck</creatorcontrib><creatorcontrib>Gaussem, Pascale</creatorcontrib><creatorcontrib>Samama, Charles-Marc</creatorcontrib><creatorcontrib>Cheurfa, Cherifa</creatorcontrib><creatorcontrib>Planquette, Benjamin</creatorcontrib><creatorcontrib>Sanchez, Olivier</creatorcontrib><creatorcontrib>Diehl, Jean-Luc</creatorcontrib><creatorcontrib>Mirault, Tristan</creatorcontrib><creatorcontrib>Fontenay, Michaela</creatorcontrib><creatorcontrib>Terrier, Benjamin</creatorcontrib><creatorcontrib>Smadja, David M</creatorcontrib><collection>PubMed</collection><jtitle>Arthritis & rheumatology (Hoboken, N.J.)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Gendron, Nicolas</au><au>Dragon-Durey, Marie-Agnès</au><au>Chocron, Richard</au><au>Darnige, Luc</au><au>Jourdi, Georges</au><au>Philippe, Aurélien</au><au>Chenevier-Gobeaux, Camille</au><au>Hadjadj, Jérôme</au><au>Duchemin, Jérôme</au><au>Khider, Lina</au><au>Yatim, Nader</au><au>Goudot, Guillaume</au><au>Krzisch, Daphné</au><au>Debuc, Benjamin</au><au>Mauge, Laetitia</au><au>Levasseur, Françoise</au><au>Pene, Frédéric</au><au>Boussier, Jeremy</au><au>Sourdeau, Elise</au><au>Brichet, Julie</au><au>Ochat, Nadège</au><au>Goulvestre, Claire</au><au>Peronino, Christophe</au><au>Szwebel, Tali-Anne</au><au>Pages, Franck</au><au>Gaussem, Pascale</au><au>Samama, Charles-Marc</au><au>Cheurfa, Cherifa</au><au>Planquette, Benjamin</au><au>Sanchez, Olivier</au><au>Diehl, Jean-Luc</au><au>Mirault, Tristan</au><au>Fontenay, Michaela</au><au>Terrier, Benjamin</au><au>Smadja, David M</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Lupus anticoagulant single positivity at acute phase is not associated with venous thromboembolism or in-hospital mortality in COVID-19</atitle><jtitle>Arthritis & rheumatology (Hoboken, N.J.)</jtitle><addtitle>Arthritis Rheumatol</addtitle><date>2021-04-21</date><risdate>2021</risdate><eissn>2326-5205</eissn><abstract>Antiphospholipid antibodies (APA) clinical relevance in COVID-19 is controversial. We aimed to investigate the prevalence and prognostic value of conventional and non-conventional APA in COVID-19 patients.
This study was a multi-centric, prospective observational French cohort of patients hospitalized for COVID-19 suspicion.
249 patients were hospitalized for suspected COVID-19, including 154 with confirmed COVID-19 and 95 not confirmed. We found a significant increase in lupus anticoagulant (LA) positivity among COVID-19 positive patients (60.9% versus 23.7% in non-COVID19 patients, p<0.001), while prevalence of conventional (anti-cardiolipin and anti-beta-2-GP1, IgG and IgM isotypes) and non-conventional APA (IgA, anti-phosphatidylserine/prothrombin and anti-prothrombin IgG and IgM) were low in both groups. COVID-19 patients with LA positivity had higher levels of fibrinogen (6.0 IQR 5.0-7.0 versus 5.3 g/L IQR 4.3-6.4, p=0.028) and C-reactive protein (CRP, 115.5 IQR 66.0-204.8 versus 91.8 mg/L IQR 27.0-155.1, p=0.019). Univariate analysis did not show any association between LA positivity and higher risk of venous thromboembolism (VTE, OR 1.02, 95% CI 0.44-2.43, p=0.95) or in-hospital mortality (OR 1.80, 95% CI 0.70-5.05, p=0.24). Unadjusted and adjusted (to CRP, age and sex) Kaplan-Meier survival curves according to LA positivity confirmed the absence of association with VTE or in-hospital mortality (unadjusted: p=0.64 and p=0.26, respectively; adjusted: hazard ratio = 1.13 95% CI 0.48-2.60 and 1.80 95% CI 0.67-5.01).
COVID-19 patients have an increased prevalence of LA positivity associated with biological inflammation markers. However, positive LA at admission is not associated with VTE risk and/or in-hospital mortality.</abstract><cop>United States</cop><pmid>33881229</pmid><doi>10.1002/art.41777</doi><orcidid>https://orcid.org/0000-0001-6612-7336</orcidid><orcidid>https://orcid.org/0000-0003-4852-4738</orcidid></addata></record> |
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| source | Wiley Online Library Journals Frontfile Complete; Alma/SFX Local Collection |
| title | Lupus anticoagulant single positivity at acute phase is not associated with venous thromboembolism or in-hospital mortality in COVID-19 |
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