[PMC free article] [PubMed] [Google Scholar] 5. anticoagulant (LA) and the prothrombotic state experienced by these Palomid 529 (P529) patients. 1 , 2 In our center, we retrospectively analyzed 27 patients who had been tested for antiphospholipid antibodies between March 13th and April 26th of 2020, during their hospital admission due Rabbit Polyclonal to PHCA to COVID\19 (confirmed by a positive RT\PCR for SARS\CoV\2 in a nasopharyngeal swab). Informed consent was obtained, and no change in clinical practice was made according to the results. All of them were on prophylactic heparin, and the determinations were made 24?hours after the last dose. Their clinical and laboratory characteristics are described in Table?1. Patients receiving warfarin or direct oral anticoagulants were excluded. TABLE 1 Characteristics of the patients thead valign=”top” th align=”left” valign=”top” rowspan=”1″ colspan=”1″ Characteristics /th th align=”left” valign=”top” rowspan=”1″ colspan=”1″ Patients (n=27) /th th align=”left” valign=”top” rowspan=”1″ colspan=”1″ Reference range /th /thead Age (years)58 (20\90)GenderFemale55,6%Male44,4%Cardiovascular risk factorsHypertension37%Dyslipidemia33%Diabetes11%Smoker14,8%Obesidad (BMI? ?30 Kg/m2)18,5%Medical historyAutoimmune disease11.1% (3/27)Cancer7% (2/27)Laboratory findingsHemoglobin13,6 (9,2\16,2)g/dL [13.0\16.8]Platelets222.000 ( 108.000\599.000)1000/L [140\450]Lymphocytes1100 (100\3100)1000/L [1.2\4.0]LDH329 (190\811)U/L [135\225]CRP7,32 (0,04\36,6)mg/dL [0.10\0.50]Ferritin1070 (137\7459)ng/mL [30\400]Fibrinogen648 (373\1412)mg/dL [200\560]IL\6252 (0\782)pg/mL [ 40]D\dimer2367 (223\8138)ng/mL [ 500]Prothrombin activity83 (60\115)% [75\140]Prothrombin time12,8 (10,7\16,5)s [9.7\13.9]aPTTTTPa: 32 (21\48)s Palomid 529 (P529) [26\39]Lupus anticoagulant22,2% (6/27)Anticardiolipin antibodies0% (0/27)Anti\B2 glycoprotein I antibodies3,7% (1/27)ICUAdmission22,2% (6/27)Median stay (days)25 (6\30)Thrombotic eventArterialLower extremities arterial ischemia 7,4% (2/27)VenousDeep vein thrombosis 22,2% (6/27)Pulmonary embolism 37% (10/27)Stroke 7,4% (2/27)Death11,1% (3/27) Open in a separate window For the detection of lupus anticoagulant (LA), the dilute Russel viper venom test (dRVVT, HemosIL?, reagent: HemosIL dRVVT Screen/Confirm, Instrumentation Laboratory, Werfen) and the silica clotting time (SCT, HemosIL?, reagent: HemosIL Silica Clotting Time, Instrumentation Laboratory, Werfen) were used with screen/confirm reagents, while for the determination of anticardiolipin (aCL) antibodies (IgM and IgG) and anti\beta\2 glycoprotein I antibodies (IgA, IgM and IgG) a serological enzyme\linked immunosorbent assay (ELISA) was performed (reagent: QUANTA aB2GPI Lite, INOVA Diagnostics). A total of 6 patients (22,2%) were positive for LA and 1 (3.7%) for IgA anti\beta\2 glycoprotein I antibodies. No double antibody positivity was found. A total of 15 patients (55,5%) had a thrombotic event from which only 3 had a positive antiphospholipid antibody determination (2 for LA, 1 for IgA anti\beta\2 Palomid 529 (P529) glycoprotein I antibodies). From them, 13 patients had thrombotic risk factors such as hypertension, dyslipidemia, diabetes, obesity, smoking habit, or cancer. A total of 6 patients (22,2%) required admission to an intensive care unit due to respiratory failure following an acute respiratory distress syndrome (ARDS), 5 of them experienced a thrombotic event, being pulmonary embolism the most frequent among them (56%). In 3/6 (50%), LA was positive. This last finding entails a higher percentage of patients with LA positivity among critical patients compared to the Palomid 529 (P529) total number of patients (22,2% of LA positivity), as described by Helms J et al. 1 A total of three patients died of respiratory failure, they all suffered at least 1 thrombotic event (1 of them endured simultaneously a deep vein thrombosis, a pulmonary Palomid 529 (P529) embolism, and an ischemic stroke), and only 1 1 had a confirmed LA. Antiphospholipid antibodies can be temporarily detected during infectious episodes, and in this specific setting, they are not clearly related to an increased thrombotic risk. Moreover, given the possibility of LA false positives due to an elevated C\reactive protein and its high affinity for phospholipids, this determination is not recommended in such episodes. 2 In accordance with Zhang et al, 3 we do not consider the testing of LA cost\effective when performed to every COVID\19 patient, because of its high variability among them. In addition, LA positivity does not seem to predict thrombotic risk or have a clinical utility in deciding when to modify antithrombotic therapy, as mentioned by Harzallah et al, 4 even though our LA positivity rate was lower (45% vs 22.2%), as it was for the remaining antiphospholipid antibodies (10% vs 3.7%). Regarding the possible usefulness of a prolonged activated?partial thromboplastin time?(aPTT) (reagent used: SynthASil, Instrumentation Laboratory, Werfen) as a guide to test for the presence of antiphospholipid antibodies, just like Bowles et al 5 and Connell et al 6 describe, we did not find it useful, only 1 1 of our 27 patients had a prolonged aPTT and presence of LA, while the remaining patients with positive LA had no coagulation abnormalities. We agree with Beyrouti R et al, 7 considering a prolonged aPTT not a very sensitive test to predict the possible positivity of LA, because of the potential interference of other factors that can shorten (such.