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  • Benjamin, L. A. (author)

Antiphospholipid antibodies and neurological manifestations in acute COVID-19: A single-centre cross-sectional study

  • Article/chapterEnglish2021

Publisher, publication year, extent ...

  • Elsevier BV,2021

Numbers

  • LIBRIS-ID:oai:gup.ub.gu.se/310668
  • https://gup.ub.gu.se/publication/310668URI
  • https://doi.org/10.1016/j.eclinm.2021.101070DOI

Supplementary language notes

  • Language:English

Part of subdatabase

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  • Subject category:ref swepub-contenttype
  • Subject category:art swepub-publicationtype

Notes

  • 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.

Subject headings and genre

Added entries (persons, corporate bodies, meetings, titles ...)

  • Paterson, R. W. (author)
  • Moll, R. (author)
  • Pericleous, C. (author)
  • Brown, R. (author)
  • Mehta, P. R. (author)
  • Athauda, D. (author)
  • Ziff, O. J. (author)
  • Heaney, J. (author)
  • Checkley, A. M. (author)
  • Houlihan, C. F. (author)
  • Chou, M. (author)
  • Heslegrave, A. J. (author)
  • Chandratheva, A. (author)
  • Michael, B. D. (author)
  • 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)
  • Vivekanandam, V. (author)
  • Foulkes, A. (author)
  • Mummerya, C. J. (author)
  • Lunn, M. P. (author)
  • Keddie, S. (author)
  • Spyer, M. J. (author)
  • McKinnon, T. (author)
  • Hart, M. (author)
  • Carletti, F. (author)
  • Jager, H. R. (author)
  • Manji, H. (author)
  • Zandi, M. S. (author)
  • Werring, D. J. (author)
  • Nastoulik, E. (author)
  • Simister, R. (author)
  • Solomon, T. (author)
  • 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)
  • Schott, J. M. (author)
  • Cohen, H. (author)
  • Efthymiou, M. (author)
  • Göteborgs universitetInstitutionen för neurovetenskap och fysiologi, sektionen för psykiatri och neurokemi (creator_code:org_t)

Related titles

  • In:Eclinicalmedicine: Elsevier BV392589-5370

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