{"doi":"10.1101/2020.06.15.20131607","title":"Prothrombotic antiphospholipid antibodies in COVID-19","abstract":"Patients with coronavirus disease 19 (COVID-19) are at high risk for thrombotic arterial and venous occlusions. At the same time, lung histopathology often reveals fibrin-based occlusion in the small vessels of patients who succumb to the disease. Antiphospholipid syndrome (APS) is an acquired and potentially life-threatening thrombophilia in which patients develop pathogenic autoantibodies (aPL) targeting phospholipids and phospholipid-binding proteins. Case series have recently detected aPL in patients with COVID-19. Here, we measured eight types of aPL [anticardiolipin IgG/IgM/IgA, anti-beta-2 glycoprotein I IgG/IgM/IgA, and anti- phosphatidylserine/prothrombin (aPS/PT) IgG/IgM] in the sera of 172 patients hospitalized with COVID-19. We detected aPS/PT IgG in 24%, anticardiolipin IgM in 23%, and aPS/PT IgM in 18%. Any aPL was present in 52% of patients using the manufacturer's threshold and in 30% using a more stringent cutoff (≥40 units). Higher levels of aPL were associated with neutrophil hyperactivity (including the release of neutrophil extracellular traps/NETs), higher platelet count, more severe respiratory disease, and lower glomerular filtration rate. Similar to patients with longstanding APS, IgG fractions isolated from patients with COVID-19 promoted NET release from control neutrophils. Furthermore, injection of these COVID-19 IgG fractions into mice accelerated venous thrombosis. Taken together, these studies suggest that a significant percentage of patients with COVID-19 become at least transiently positive for aPL and that these aPL are potentially pathogenic.","journal":"medRxiv","year":2020,"id":118514,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":67,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.9626,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2020-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":109628,"name":"Shanea K. Estes","orcid":null,"position":1,"is_corresponding":false},{"id":109629,"name":"Ramadan A. Ali","orcid":"0000-0003-1507-1517","position":2,"is_corresponding":false},{"id":109630,"name":"Alex A. Gandhi","orcid":null,"position":3,"is_corresponding":false},{"id":105691,"name":"Srilakshmi Yalavarthi","orcid":"0009-0005-9128-572X","position":4,"is_corresponding":false},{"id":109631,"name":"Hui Shi","orcid":"0000-0002-3574-8807","position":5,"is_corresponding":false},{"id":109632,"name":"Gautam Sule","orcid":null,"position":6,"is_corresponding":false},{"id":105693,"name":"Kelsey Gockman","orcid":null,"position":7,"is_corresponding":false},{"id":105695,"name":"Jacqueline A. Madison","orcid":"0000-0003-1745-8133","position":8,"is_corresponding":false},{"id":105694,"name":"Melanie Zuo","orcid":null,"position":9,"is_corresponding":false},{"id":109633,"name":"Vinita Yadav","orcid":"0000-0003-1026-5697","position":10,"is_corresponding":false},{"id":550816,"name":"Jintao Wang","orcid":"0000-0001-5958-1194","position":11,"is_corresponding":false},{"id":261393,"name":"Wrenn Woodward","orcid":null,"position":12,"is_corresponding":false},{"id":109636,"name":"Sean P. Lezak","orcid":null,"position":13,"is_corresponding":false},{"id":109637,"name":"Njira Lugogo","orcid":"0000-0002-0235-7105","position":14,"is_corresponding":false},{"id":277511,"name":"Stephanie A. Smith","orcid":"0000-0003-4895-6215","position":15,"is_corresponding":false},{"id":109638,"name":"James H. Morrissey","orcid":"0000-0002-1570-1569","position":16,"is_corresponding":false},{"id":105700,"name":"Yogendra Kanthi","orcid":"0000-0002-5660-5194","position":17,"is_corresponding":false},{"id":105701,"name":"Jason S. Knight","orcid":"0000-0003-0995-9771","position":18,"is_corresponding":false},{"id":259811,"name":"Yu Zuo","orcid":"0000-0001-6721-7755","position":0,"is_corresponding":true}],"reference_count":102,"raw_metadata":null,"created_at":"2026-07-18T23:13:58.531532Z","pmid":"32587992","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}