Abstract Number: PB0188
Meeting: ISTH 2021 Congress
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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