Antiphospholipid syndrome in the era of COVID-19 – Two sides of a coin

Naim Mahroum*, Mona Habra, Mohamad Aosama Alrifaai, Yehuda Shoenfeld

*Corresponding author for this work

Research output: Contribution to journalReview articlepeer-review

Abstract

In addition to the respiratory symptoms associated with COVID-19, the disease has consistently been linked to many autoimmune diseases such as systemic lupus erythematous and antiphospholipid syndrome (APS). APS in particular was of paramount significance due to its devastating clinical sequela. In fact, the hypercoagulable state seen in patients with acute COVID-19 and the critical role of anticoagulant treatment in affected individuals shed light on the possible relatedness between APS and COVID-19. Moreover, the role of autoimmunity in the assumed association is not less important especially with the accumulated data available regarding the autoimmunity-triggering effect of SARS-CoV-2 infection. This is furtherly strengthened at the time patients with COVID-19 manifested antiphospholipid antibodies of different types following infection. Additionally, the severe form of the APS spectrum, catastrophic APS (CAPS), was shown to have overlapping characteristics with severe COVID-19 such as cytokine storm and multi-organ failure. Interestingly, COVID vaccine-induced autoimmune phenomena described in the medical literature have pointed to an association with APS. Whether the antiphospholipid antibodies were present or de novo, COVID vaccine-induced vascular thrombosis in certain individuals necessitates further investigations regarding the possible mechanisms involved. In our current paper, we aimed to focus on the associations mentioned, their implications, importance, and consequences.

Original languageEnglish
Article number103543
JournalAutoimmunity Reviews
Volume23
Issue number9
DOIs
StatePublished - Sep 2024
Externally publishedYes

Keywords

  • Antiphospholipid syndrome
  • Autoantibodies
  • Autoimmunity
  • COVID-19
  • Hypercoagulability
  • SARS-CoV-2

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