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Antiphospholipid an...
Antiphospholipid antibodies and neurological manifestations in acute COVID-19: A single-centre cross-sectional study
- Article/chapterEnglish2021
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LIBRIS-ID:oai:gup.ub.gu.se/310668
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https://gup.ub.gu.se/publication/310668URI
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https://doi.org/10.1016/j.eclinm.2021.101070DOI
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Subject category:ref swepub-contenttype
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Subject category:art swepub-publicationtype
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Background: A high prevalence of antiphospholipid antibodies has been reported in case series of patients with neurological manifestations and COVID-19; however, the pathogenicity of antiphospholipid antibodies in COVID-19 neurology remains unclear. Methods: This single-centre cross-sectional study included 106 adult patients: 30 hospitalised COVID-neurological cases, 47 non-neurological COVID-hospitalised controls, and 29 COVID-non-hospitalised controls, recruited between March and July 2020. We evaluated nine antiphospholipid antibodies: anticardiolipin antibodies [aCL] IgA, IgM, IgG; anti-beta-2 glycoprotein-1 [a beta(2)GPI] IgA, IgM, IgG; anti-phosphatidylserine/prothrombin [aPS/PT] IgM, IgG; and anti-domain I b2GPI (aD1 beta 2GPI) IgG. Findings: There was a high prevalence of antiphospholipid antibodies in the COVID-neurological (73.3%) and non-neurological COVID-hospitalised controls (76.6%) in contrast to the COVID-non-hospitalised controls (48.2%). aPS/PT IgG titres were significantly higher in the COVID-neurological group compared to both control groups (p < 0.001). Moderate-high titre of aPS/PT IgG was found in 2 out of 3 (67%) patients with acute disseminated encephalomyelitis [ADEM]. aPS/PT IgG titres negatively correlated with oxygen requirement (FiO(2) R=-0.15 p = 0.040) and was associated with venous thromboembolism (p = 0.043). In contrast, aCL IgA (p < 0.001) and IgG (p < 0.001) was associated with non-neurological COVID-hospitalised controls compared to the other groups and correlated positively with D-dimer and creatinine but negatively with FiO(2). Interpretation: Our findings show that aPS/PT IgG is associated with COVID-19-associated ADEM. In contrast, aCL IgA and IgG are seen much more frequently in non-neurological hospitalised patients with COVID-19. Characterisation of antiphospholipid antibody persistence and potential longitudinal clinical impact are required to guide appropriate management. (C) 2021 The Author(s). Published by Elsevier Ltd.
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Paterson, R. W.
(author)
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Moll, R.
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Pericleous, C.
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Brown, R.
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Mehta, P. R.
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Athauda, D.
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Ziff, O. J.
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Heaney, J.
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Checkley, A. M.
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Houlihan, C. F.
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Chou, M.
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Heslegrave, A. J.
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Chandratheva, A.
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Michael, B. D.
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Blennow, Kaj,1958Gothenburg University,Göteborgs universitet,Institutionen för neurovetenskap och fysiologi, sektionen för psykiatri och neurokemi,Institute of Neuroscience and Physiology, Department of Psychiatry and Neurochemistry(Swepub:gu)xbleka
(author)
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Vivekanandam, V.
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Foulkes, A.
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Mummerya, C. J.
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Lunn, M. P.
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Keddie, S.
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Spyer, M. J.
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McKinnon, T.
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Hart, M.
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Carletti, F.
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Jager, H. R.
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Manji, H.
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Zandi, M. S.
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Werring, D. J.
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Nastoulik, E.
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Simister, R.
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Solomon, T.
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Zetterberg, Henrik,1973Gothenburg University,Göteborgs universitet,Institutionen för neurovetenskap och fysiologi, sektionen för psykiatri och neurokemi,Institute of Neuroscience and Physiology, Department of Psychiatry and Neurochemistry(Swepub:gu)xzethe
(author)
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Schott, J. M.
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Cohen, H.
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Efthymiou, M.
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Göteborgs universitetInstitutionen för neurovetenskap och fysiologi, sektionen för psykiatri och neurokemi
(creator_code:org_t)
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In:Eclinicalmedicine: Elsevier BV392589-5370
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Benjamin, L. A.
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Paterson, R. W.
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Moll, R.
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Pericleous, C.
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Brown, R.
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Mehta, P. R.
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show more...
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Athauda, D.
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Ziff, O. J.
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Heaney, J.
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Checkley, A. M.
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Houlihan, C. F.
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Chou, M.
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Heslegrave, A. J ...
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Chandratheva, A.
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Michael, B. D.
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Blennow, Kaj, 19 ...
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Vivekanandam, V.
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Foulkes, A.
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Mummerya, C. J.
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Lunn, M. P.
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Keddie, S.
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Spyer, M. J.
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McKinnon, T.
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Hart, M.
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Carletti, F.
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Jager, H. R.
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Manji, H.
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Zandi, M. S.
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Werring, D. J.
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Nastoulik, E.
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Simister, R.
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Solomon, T.
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Zetterberg, Henr ...
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Schott, J. M.
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Cohen, H.
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Efthymiou, M.
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- MEDICAL AND HEALTH SCIENCES
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University of Gothenburg