Coagulopathy and Antiphospholipid Antibodies with Covid-19 Save

The New England Journal of Medicine has featured a report of three COVID infected patients, who developed peripheral and central infarcts with a antiphospholipid antibodies. 

All patients, who were hospitalized in Wuhan, China, had severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection that was confirmed by PCR  assay or serologic testing.

The index case was a 69-year-old man with a history of hypertension, diabetes, and stroke who presented with fever, cough, dyspnea, diarrhea, and headache who developed respiratory failure and mechanical ventilation.  The patients developed ischemia in the lower limbs and fingers on the left hand. Computed tomographic imaging of the brain showed bilateral cerebral infarcts. Serologic testing found IgA anticardiolipin antibodies as well as anti–β2-glycoprotein I IgA and IgG antibodies.

Two other patients with similar findings also had anticardiolipin IgA antibodies as well as anti–β2-glycoprotein I IgA and IgG antibodies.

Its unknown if these antibodies are pathogenic or epiphenomenal as these antibodies uncommonlylead to thrombotic events.