Lupus Anticoagulant Tied to COVID Thrombosis- JAMA Study
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Prothrombotic autoantibodies were elevated in COVID-19 and linked to development of thrombosis, a small observational study showed.

This retrospective study included 187 patients with LA testing ordered, at Montefiore Medical Center. The comparator group for the COVID-19 patients was the 119 who were not tested, or were negative by PCR testing, for the SARS-CoV-2 virus.

Lupus anticoagulant (LA) appeared in 44% of COVID-19 patients tested versus 22% of other patients. In the COVID-19 group, 63% of the LA-positive patients had documented arterial or venous thrombosis compared with 34% of the LA-negative patients, the group reported in JAMA Network Open.

CRP levels were higher with LA positivity but not linked with thrombosis. On the other hand, LA remained a significant independent predictor of thrombosis after adjusting for CRP, with an odds ratio of 4.39.

"LA-positive individuals have a marked risk of arterial and venous thrombosis, and therapeutic anticoagulation should be considered in these patients," the group concluded.

Prior series of COVID-19 patients have also found high LA-positive prevalence. For example, an observational study that is often referenced in support of inpatient anticoagulation for COVID-19, based on a suggestion of mortality benefit, found 91% LA positive among the 34 patients tested for it, significantly more than seen in historical controls.

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