Lupus anticoagulant and outcome of COVID-19 patients

Document Type

Conference Proceeding

Publication Date

10-1-2021

Publication Title

Research and Practice in Thrombosis and Haemostasis

Abstract

Background : Patients with coronavirus disease 2019 (COVID-19) are at increased risk of thromboembolic events, partly due to the procoagulant state and excessive inflammatory response to the infection. An increased prevalence of lupus anticoagulant (LAC) among Covid-19 patients has been reported, which emphasized the acquired prothrombotic state during COVID-19. However, most published studies were conducted on patients receiving anticoagulants or expressing high C-reactive protein (CRP) levels, both of which are known to interfere with LAC testing. Aims : To study LAC and outcome of COVID-19 patients. Methods : Retrospective review of COVID-19 patients evaluated for LAC between March 2020 and December 2020 at a tertiary-care center. The study was approved by the Institutional Review Board. We included cases tested for LAC within 30 days from positive COVID-19 testing. Patients were not on anticoagulation at the time of LAC testing. Our special coagulation laboratory follows a strict triaging process for LAC requests, and specimens containing anticoagulants are cancelled. LAC testing follows an algorithm utilizing two parallel methods: dilute Russell's viper venom time and PTTlupus anticoagulant, including their respective confirmatory testing. Eligible patients were stratified by the LAC testing results. Analyses were performed using SPSS; a P value of <0.05 was considered significant. Results : 19 patients were included; 10 were LAC-positive. The median age was 46 years (Range 23-83); 13 (68%) were females. There was no difference between LAC-positive and LAC-negative patients in age, gender, race, comorbid conditions (results not shown), CRP levels, thrombotic events, need for ICU care, or survival Conclusions : Covid-19 patients with positive LAC had longer hospital stay than patients with negative LAC. We have eliminated anticoagulation interference and false-positive testing. Our results warrant further testing in larger cohorts.

PubMed ID

Not assigned.

Volume

5

Issue

SUPPL 2

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