What question did this study set out to answer?

The study aims to evaluate the association between antiphospholipid antibodies and the severity of COVID-19 outcomes.

February 2, 2026BMC Infectious Diseases0 citationsOpen Access

Effects of antiphospholipid antibodies in the severity and outcome of COVID-19

BZBatool ZamaniKashan University of Medical Sciences MNMaedeh NajafizadehKashan University of Medical Sciences AJAtiye JokarKashan University of Medical Sciences

Key Points

The study aims to evaluate the association between antiphospholipid antibodies and the severity of COVID-19 outcomes.
Serum samples collected from 95 individuals with COVID-19
Measured levels of aPL, LA, and IgM/IgG antibodies using enzyme-linked immunosorbent assay
Conducted mixing tests for patients with prolonged aPTT to identify coagulation issues
Assessed immune cell percentages and biochemical marker values
Significant increase in IgG aβ2GPI and IgG aPL levels in patients with severe COVID-19 compared to moderate cases (P < 0.05)
Increased prevalence of LA in severe patients with prolonged aPTT and PT (P < 0.01-0.05)
Higher IgM/IgG aPL, aCL, and aβ2GPI levels in ICU patients (P < 0.01-0.05)
Non-survivors showed significantly higher levels of IgM aCL and IgG aPL (P < 0.001-0.05)

Abstract

OBJECTIVE: A high prevalence of antiphospholipid antibodies (aPL) has been reported in patients with coronavirus disease 2019 (COVID-19). Although some studies have demonstrated roles for aPL in thrombotic events in COVID-19, findings on their association with disease development and outcomes remain heterogeneous. Therefore, this study investigated whether aPL may serve as effective markers for determining the development and outcome of COVID-19. METHODS: Serum samples were isolated from whole blood of 95 individuals with moderate and severe COVID-19. The prevalence of lupus anticoagulant (LA), IgM/IgG antiphospholipid (aPL), IgM/IgG anti-β2-glycoprotein I (aβ2GPI), and IgM/IgG anticardiolipin (aCL) antibodies was measured by enzyme-linked immunosorbent assay. A mixing test was performed in patients with unexplained prolongation of activated partial thromboplastin time (aPTT) to distinguish coagulation factor deficiencies from factor inhibitors. The percentage of selected immune cells and values of biochemical markers were also assessed. RESULTS: Patients with severe COVID-19 showed significant increases in IgG aβ2GPI and IgG aPL antibody levels compared with individuals with moderate COVID-19 (P < 0.05). The mixing test showed that LA had an increased prevalence in severe patients with unexplained prolongation of aPTT and prothrombin time (PT) (P < 0.01-0.05). No significant differences were observed in IgM/IgG aCL, IgM aPL, or IgM aβ2GPI antibody levels between severe and moderate cases. Additional findings revealed that severe COVID-19 patients who required intensive care unit (ICU) treatment had significant increases in IgM/IgG aPL, IgM/IgG aCL, and IgM/IgG aβ2GPI antibodies (P < 0.01-0.05). However, there was no significant change in the prevalence of LA or IgM aβ2GPI antibodies between severe patients who required ICU therapy and those who did not. IgM aCL and IgG aPL values were significantly higher in non-survivors compared with survivors (P < 0.001-0.05). A similar trend was observed for IgG aCL and IgM aPL levels in non-survivors, although these increases were not statistically significant. CONCLUSION: Changes in aPL levels may be considered effective markers for clarifying the severity and outcome of COVID-19. CLINICAL TRIAL: Not applicable.

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