IgA is the predominant isotype of anti-β2 glycoprotein I in patients with COVID-19

Lab Med. 2024 May 2;55(3):373-379. doi: 10.1093/labmed/lmad097.

Abstract

Objective: The aim of this research was to determine the frequency of antiphospholipid antibodies (aPL) in patients with COVID-19.

Methods: The frequency and titers of anticardiolipin antibodies (aCL) and anti-β2 glycoprotein I antibodies (aβ2GPI) were determined in sera of adult patients hospitalized with COVID-19. Immunoglobulin (Ig)G, IgA, IgM aCL, and aβ2GPI were measured using enzyme-linked immunosorbent assay.

Results: Eighty-three patients were included in the study. The mean age of patients was 62 ± 13.9 years, ranging from 23 to 86 years. Stratification according to severity of infection divided patients in 2 groups: 45 patients with moderate infection and 38 patients with critical or severe infection. Out of the 83 patients suffering from COVID-19, aPL (aCL or aβ2GPI) were detected in 24 patients (28.9%). IgG, IgA and IgM aβ2GPI were positive in 2.4%, 16.9% and 8.4%, respectively. IgG, IgA and IgM aCL showed positivity in 7.2%, 0%, and 4.8%, respectively. The frequency of aPL was 36.8% in patients with critical/severe infection and 22.2% in patients with moderate infection. In critical/severe patients, the frequency of aβ2GPI was significantly higher than aCL (34.2% vs 13.2%, P = .03) and aβ2GPI-IgA were significantly more frequent than aβ2GPI-IgG (21.1% vs 2.6%, P = .028).

Conclusion: In this cross-sectional study, aPL and particularly aβ2GPI-IgA were common in patients with COVID-19.

Keywords: COVID-19; adults; anti-β2 glycoprotein I antibodies; anticardiolipin antibodies; antiphospholipid antibodies; autoimmunity.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Antibodies, Anticardiolipin / blood
  • Antibodies, Antiphospholipid / blood
  • COVID-19* / blood
  • COVID-19* / immunology
  • Enzyme-Linked Immunosorbent Assay
  • Female
  • Humans
  • Immunoglobulin A* / blood
  • Immunoglobulin M / blood
  • Immunoglobulin M / immunology
  • Male
  • Middle Aged
  • SARS-CoV-2* / immunology
  • Young Adult
  • beta 2-Glycoprotein I* / immunology

Substances

  • Immunoglobulin A
  • beta 2-Glycoprotein I
  • Antibodies, Antiphospholipid
  • Antibodies, Anticardiolipin
  • Immunoglobulin M