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. 2022 Sep 16;6(6):e12809.
doi: 10.1002/rth2.12809. eCollection 2022 Aug.

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

Tessa Noordermeer  1 , Roger E G Schutgens  1 , Chantal Visser  2 , Emma Rademaker  3 , Moniek P M de Maat  2 , A J Gerard Jansen  2 , Maarten Limper  4 , Olaf L Cremer  5 , Marieke J H A Kruip  2 , Henrik Endeman  6 , Coen Maas  7 , Bas de Laat  8 , Rolf T Urbanus  1 ; Dutch COVID & Thrombosis Coalition (DCTC)
Collaborators, Affiliations

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

Tessa Noordermeer et al. Res Pract Thromb Haemost. .

Erratum in

  • Corrigendum.
    [No authors listed] [No authors listed] Res Pract Thromb Haemost. 2022 Oct 28;6(7):e12836. doi: 10.1002/rth2.12836. eCollection 2022 Oct. Res Pract Thromb Haemost. 2022. PMID: 36320426 Free PMC article.

Abstract

Background: 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: To investigate if LA is associated with thrombosis in critically ill patients with COVID-19.

Patients/methods: 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: 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: Lupus anticoagulant on admission is strongly associated with thrombosis in critically ill patients with COVID-19, especially in patients aged less than 65 years.

Keywords: COVID‐19; critically ill; lupus anticoagulant; risk factor; thrombosis.

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