Anti-PF4 antibodies and their relationship with COVID infection

Chieh Yang; Irene Wang; Akshit Chitkara; Jibin Swankutty; Rushin Patel; Samir V Kubba

doi:10.1016/j.htct.2023.11.012

Anti-PF4 antibodies and their relationship with COVID infection

Hematol Transfus Cell Ther. 2024 Feb 1:S2531-1379(24)00005-1. doi: 10.1016/j.htct.2023.11.012. Online ahead of print.

Authors

Chieh Yang¹, Irene Wang¹, Akshit Chitkara¹, Jibin Swankutty¹, Rushin Patel², Samir V Kubba³

Affiliations

¹ School of Medicine, University of California Riverside, USA.
² Community hospital of San Bernardino, CA, USA.
³ School of Medicine, University of California Riverside, USA. Electronic address: svkubba@gmail.com.

PMID: 38388299
DOI: 10.1016/j.htct.2023.11.012

Abstract

Detecting anti-PF4 antibodies remains the golden diagnostic method for heparin-induced thrombocytopenia (HIT) diagnosis with high sensitivity and specificity. Various lab tests detect anti-PF4 antibodies, including immunoassays and functional assays. Even with positive detection of the anti-PF4 antibody, several factors are involved in the result. The concept of anti-PF4 disorders was recently brought to light during the COVID pandemic since the development of vaccine-induced thrombotic thrombocytopenia (VITT) with the adenovirus-vectored-DNA vaccine during the pandemic. Circumstances that detect anti-PF4 antibodies are classified as anti-PF4 disorders, including VITT, autoimmune HIT and spontaneous HIT. Some studies showed a higher percentage of anti-PF4 antibody detection among the population infected by COVID-19 without heparin exposure and some supported the theory that the anti-PF4 antibodies were related to the disease severity. In this review article, we provide a brief review of anti-PF4 disorders and summarize the current studies of anti-PF4 antibodies and COVID-19 infection.

Keywords: Anti-platelet factor 4 antibodies; COVID-19; Heparin-induced thrombocytopenia; SARS-CoV-2; Vaccine-induced immune thrombotic thrombocytopenia.

Publication types

Review