Incidence of lupus anticoagulant in hospitalized covid-19 patients

Tarek Owaidah; Mahasen Saleh; Amelita M Aguilos; Abdulllah Al Amri; Khalid Maghrabi; Mustafa Owaidah; Khawar Siddiqui; Khalid Alsaleh; Randa Alnounou

Incidence of lupus anticoagulant in hospitalized covid-19 patients

Am J Blood Res. 2021 Jun 15;11(3):317-324. eCollection 2021.

Authors

Tarek Owaidah^{1

2}, Mahasen Saleh³, Amelita M Aguilos¹, Abdulllah Al Amri¹, Khalid Maghrabi⁴, Mustafa Owaidah², Khawar Siddiqui³, Khalid Alsaleh⁵, Randa Alnounou¹

Affiliations

¹ Department of Pathology and Laboratory Medicine, King Faisal Specialist Hospital and Research Centre Riyadh 11211, KSA.
² Alfaisal University Riyadh 11533, KSA.
³ Department of Pediatric Hematology Oncology, King Faisal Specialist Hospital and Research Centre Riyadh 11211, KSA.
⁴ Department of Critical Care, King Faisal Specialist Hospital and Research Centre Riyadh 11211, KSA.
⁵ Department of Medicine, College of Medicine, King Saud University Riyadh 12372, KSA.

PMID: 34322296
PMCID: PMC8303017

Abstract

Background: Procoagulant profile of 2019-nCoV/SARS-CoV-2 has been well documented over the last year. Perturbance in coagulating factors has also been reported in Covid-19 patients, including increased d-dimers and reports of lupus anticoagulant (LA).

Methods: The current study aimed to identify the incidence of positivity of lupus anticoagulant in Covid-19 patients and analyze the association between LA and D-dimer in predicting thrombosis and mortality in one-hundred and five hospitalized adult (age >14 years) patients and forty-three hospitalized pediatric (age <14 years) patients with a confirmed diagnosis of Covid-19 between June 2020 and September 2020.

Results: Twenty-one (20%) adult patients were tested positive for PTT LA, of which nine (8.6%) turned out to be confirmed positive for LA through StaClot and DRVVT Ratio tests. Six (14%) pediatric patients were positive for PTT LA, and only one (2.3%) had positive StaClot. Median D-dimer at admission was positively correlated with age and CRP among adult patients and was significantly higher in expired cases (P=0.001). No association between any of the coagulation tests and thrombosis or mortality was observed in the pediatric cohort.

Conclusion: We report an increased incidence of LA in Covid-19 patients, yet we didn't find any association between thrombotic events or mortality, probably due to the small sample size.

Keywords: Covid-19; D-dimers; lupus anti-coagulant; thrombosis.