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COVID-19 Pneumonia Worse Prognosis Related to Lupus Anticoagulant Transient Positive Test

J.M. Ceresetto1, S. Rivarola2, C. Duboscq1, M. Carreras1, A. Cantillo1, L. Zapata1, K. Oliveros1, A. Avila1, C. Sernaque1, M. Quarchioni1, N. Flegler1, S. Palmer1, G. Stemmelin1

1Hospital Britanico de Buenos Aires, Buenos Aires, Argentina, 2Hospital Britanico de Buenos Aires, Buenoas Aires, Argentina

Abstract Number: PB0188

Meeting: ISTH 2021 Congress

Theme: COVID and Coagulation » COVID and Coagulation, Clinical

Background: Lupus anticoagulant (LAC) has been reported in almost 50% of patients with COVID-19 disease, but its significance is not clear yet.  

Aims: To evaluate prospectively the presence of LAC test in hospitalized symptomatic COVID-19 pneumonia patients and to report clinical evolution, thromboembolism (VTE), bleeding events, and persistence of the LAC positive (LAC+) 1-3 months after discharge.

Methods: 278 patients hospitalized with COVID-19 symptomatic disease (August-November 2020). LAC was performed according to ISTH guidelines. Heparin must be <0.35antiXaU/mL. D-dimer (immunoturbidimetic) was performed with initial laboratory. Patients were followed for any thrombotic/hemorrhagic events for three months. Chi-square test and multivariate logistic regression (statistix 7.0) were used for the statistical analysis.

Results: From 278 patients with COVID-19 admitted at the hospital, 149 (54%) had LAC+ in the first 48 hours. Most of them were dRVVT positive, only 12/149 had both dRVVT/SCT positive. Average age 59 (range18-92) 103 males and this wasn´t different from LAC(-). 46/278 (17%) patients required intensive care admission for ventilatory support, 9 (3%) had clinical VTE, 5 (2%) had major bleeding and 16 (6%) died. LAC+ patients had significantly more severe COVID-19 pneumonia as they required more intensive care support (34 vs 12 patients p=0.002) and died more (13 vs 3 deaths p=0.003) They also had more VTE (7vs2). Five patients had major bleeding (three LAC+, two LAC(-) but 4/5 were under full dose anticoagulation (three AF, one VTE). D-dimer was nor different between LAC+/LAC(-) patients (average 1104 ng/FEU LAC+, 1249 ng/FEU LAC(-). A new LAC was performed 1-3 months after discharge in 63/137 (46%) patients. No one had thrombosis and 43/63 (68%) had LAC(-) when COVID-19 resolved.

Conclusions: LAC+ seems to be related to worse prognosis as they required more intensive care support and died more in patients with COVID-19 disease, although this pro thrombotic condition is transitory in most of them.

To cite this abstract in AMA style:

Ceresetto JM, Rivarola S, Duboscq C, Carreras M, Cantillo A, Zapata L, Oliveros K, Avila A, Sernaque C, Quarchioni M, Flegler N, Palmer S, Stemmelin G. COVID-19 Pneumonia Worse Prognosis Related to Lupus Anticoagulant Transient Positive Test [abstract]. Res Pract Thromb Haemost. 2021; 5 (Suppl 2). https://abstracts.isth.org/abstract/covid-19-pneumonia-worse-prognosis-related-to-lupus-anticoagulant-transient-positive-test/. Accessed November 29, 2023.

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