Detection frequency and duration of lupus anticoagulant circulation in COVID-19 patients

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Abstract

The aim of the work was to determine frequency of lupus anticoagulant (LA) detection in patients at various degrees of COVID-19 severity as well as duration of LA circulation after the infectious disease. The study included 103 patients with COVID-19. The patients were observed during the hospital care and in ambulance, if required. The patients were admitted to the departments of infectious diseases arranged at the V.I.Kulakov National Medical Research Center for Obstetrics, Gynecology, and F.I. Inozemtsev City Clinical Hospital. Treatment schedules and stratification of the patients by clinical severity was carried out in accordance with Interim Guidelines issued by the Ministry of Health of the Russian Federation for the prevention, diagnosis and treatment of new coronavirus infection (version 9). The following groups were formed: mild (n = 27), moderate (n = 55) and severe (n = 20). The patients were tested for LA positivity in the course of disease: on the day of starting medical care (with outpatient observation), or on the day of hospitalization; repeated tests were made before discharge (inpatients), and later, 1-2 months and 7 months after recovery. Lupus anticoagulant was determined by two independent tests (dRVVT and SCT), i.e., as a screening test and a confirmation test. At initial examination, LA was found in 50 patients (49%). The effect of LA in 98% of cases was observed with dRVVT test, as an increase of normalized ratio (NR). The maximum median value of NR was 1.54 (0.97: 2.1) was revealed in patients with severe course of COVID-19 (p < 0.0001) compared with other groups and correlated with severity of the infectious process (r = 0.491, p < 0.0001). In mild cases of COVID-19, LA was detected less often (4 cases, 14.8%) than in moderate severity cases (27, 49.1%), and severe patients (19, 95%) (p < 0.05). Re-examinations of the patients before discharge from the hospital and 1-2 months later revealed high frequency of LA (p < 0.05). However, no LA-positive test was found 7 months after discharge. In patients with COVID-19, high frequency of circulating LA was registered, depending on severity of the infectious process. In addition, we have first shown that persistence of the circulating LA over post-infectious period does not exceed 7 months. 

About the authors

O. S. Beznoshchenko

V. Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology

Author for correspondence.
Email: ospa-a@yandex.ru
ORCID iD: 0000-0003-4645-8976

Doctor for Clinical Laboratory Diagnostics, Junior Research Associate, Laboratory of Clinical Immunology

117997, Moscow, Acad. Oparin str., 4

Russian Federation

M. A. Shpilyuk

V. Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology

Email: tambovtsevamr@mail.ru
ORCID iD: 0000-0001-5145-7981

Research Associate, Laboratory of Clinical Immunology

117997, Moscow, Acad. Oparin str., 4

Russian Federation

T. Yu. Ivanets

V. Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology

Email: t_ivanets@oparina4.ru
ORCID iD: 0000-0002-7990-0276

PhD, MD (Medicine), Head, Clinical Diagnostic Laboratory

117997, Moscow, Acad. Oparin str., 4

Russian Federation

L. V. Krechetova

V. Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology

Email: l_krechetova@oparina4.ru
ORCID iD: 0000-0001-5023-3476

PhD, MD (Medicine), Head, Laboratory of Clinical Immunology

117997, Moscow, Acad. Oparin str., 4

Russian Federation

A. V. Pyregov

V. Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology

Email: a_pyregov@oparina4.ru
ORCID iD: 0000-0001-8382-9671

PhD, MD (Medicine), Professor, Director of the Institute of Anesthesiology, Reanimatology and Transfusiology

117997, Moscow, Acad. Oparin str., 4

Russian Federation

D. S. Kodatsky

V. Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology

Email: d_kodatskiy@oparina4.ru
ORCID iD: 0000-0001-9707-3473

Anesthesiologist-Reanimatologist

117997, Moscow, Acad. Oparin str., 4

Russian Federation

E. V. Tavluyeva

F. Inozemtsev City Clinical Hospital

Email: tavlev@mail.ru

PhD, MD (Medicine), Deputy Chief Physician for Medical Affairs

Moscow

Russian Federation

A. R. Melkumyan

F. Inozemtsev City Clinical Hospital

Email: alinamelkumyan@yandex.ru

PhD (Medicine), Doctor for Clinical Laboratory Diagnostics, Head, Center of the Laboratory Diagnostics

Moscow

Russian Federation

E. A. Gorodnova

V. Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology

Email: e_gorodnova@oparina4.ru
ORCID iD: 0000-0002-9524-4416

PhD (Medicine), Head, Center for Scientific and Clinical Research

117997, Moscow, Acad. Oparin str., 4

N. V. Dolgushina

V. Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology

Email: n_dolgushina@oparina4.ru

PhD, MD (Medicine), Professor, Deputy Director, Head, Department of Organization of Scientific Activities

117997, Moscow, Acad. Oparin str., 4

Russian Federation

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Copyright (c) 2021 Beznoshchenko O.S., Shpilyuk M.A., Ivanets T.Y., Krechetova L.V., Pyregov A.V., Kodatsky D.S., Tavluyeva E.V., Melkumyan A.R., Gorodnova E.A., Dolgushina N.V.

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This work is licensed under a Creative Commons Attribution 4.0 International License.
Свидетельство о регистрации СМИ ПИ № 77 - 11525 от 04.01.2002 выдано Федеральной службой по надзору в сфере связи, информационных технологий и массовых коммуникаций (Роскомнадзор).


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