Evaluation of the Association between Antiphospholipid Antibodies and ICU Admission Outcome in Critically Ill COVID-19 Patients in Iranian Population

Bahram Pakzad; Marzieh Salehi; Saeed Abbasi; Mohammad Mahdi Salehi; Maryam Kazemi Naeini; Hassan Salehi

doi:10.4103/ijpvm.ijpvm_518_21

Evaluation of the Association between Antiphospholipid Antibodies and ICU Admission Outcome in Critically Ill COVID-19 Patients in Iranian Population

Int J Prev Med. 2022 Nov 23:13:140. doi: 10.4103/ijpvm.ijpvm_518_21. eCollection 2022.

Authors

Bahram Pakzad¹, Marzieh Salehi², Saeed Abbasi³, Mohammad Mahdi Salehi⁴, Maryam Kazemi Naeini⁵, Hassan Salehi⁶

Affiliations

¹ Division of Rheumatology, Department of Internal Medicine, School of Medicine, Isfahan University of Medical Science, Isfahan, Iran.
² Department of Internal Medicine, School of Medicine, Isfahan University of Medical Science, Isfahan, Iran.
³ Anesthesiology and Critical Care Research Center, School of Medicine, Isfahan University of Medical Science, Isfahan, Iran.
⁴ Department of Oral Health Science, Faculty of Dentistry, University of British Columbia, Vancouver, British Columbia, Canada.
⁵ Department Biostatistics and Epidemiology, School of Health, Isfahan University of Medical Science, Isfahan, Iran.
⁶ Infectious Diseases and Tropical Medicine Research Center, School of Medicine, Isfahan University of Medical Science, Isfahan, Iran.

Abstract

Background: The role of anti-phospholipid antibodies (aPLs) in the prognosis of COVID-19 patients is controversial. In order to prove the role of this factor, the necessary measures such as early initiation of anticoagulants should be started even in the early stages of the disease and in outpatients or the use of other drugs in addition to anticoagulants. We decided to investigate the role of these antibodies in ICU admission outcomes in critically ill COVID-19 patients.

Methods: The case-control study was carried out in Isfahan, Iran, from March to September 2021. One hundred nine patients in the case group were selected, including patients admitted to the ICU with a COVID-19 diagnosis. The 140 patients in the control group were selected from hospitalized and outpatients with COVID-19 with PCR + and pulmonary involvement, similar to the case group without the need for ICU hospitalization. The anti B2GP1 (IgM, IgG) and anti-cardiolipin (IgM, IgG)) were compared in two groups.

Results: The frequency percentage of patients in the abnormal group of anti-phospholipid antibodies was about 10% in total. No statistically significant difference in these aPLs in continued measures was observed between the two groups of patients admitted to the ICU and those outside the ICU. Also, in the logistics regression analysis, no significant association was observed.

Conclusions: Therefore, the cause of coagulation in patients admitted to the ICU is not related to these aPLs. This means that aPLs could not be a good predictor of patient admission to the ICU.

Keywords: Antiphospholipid antibodies; COVID-19; ICU admission.