Abstract：
BACKGROUND: Coronavirus disease-2019 (COVID-19) is associated with thromboembolism. Antiphospholipid antibody (APLa) formation is one of the mechanisms. Vitamin D deficiency has been associated with thrombosis in antiphospholipid antibody syndrome.
OBJECTIVE: Measure APLa and vitamin D in hospitalized COVID-19 patients with and without thrombosis to evaluate if thromboembolism is associated with concomitant APLa and vitamin D deficiency.
METHODS: Case-control study. Hospitalized COVID-19 patients with a thromboembolic event (ischemic stroke, myocardial infarction, deep venous thrombosis/pulmonary embolism, Cases n = 20). Controls (n = 20): Age, sex-matched without thromboembolic events. Patients with autoimmune disorders, antiphospholipid antibody syndrome, thrombophilia, anticoagulation therapy, prior thromboembolism, chronic kidney disease 3b, 4, end-stage renal disease, and malignancy were excluded. Given the limited current literature on the role of concomitant antiphospholipid antibodies and vitamin D deficiency in causing venous and/or arterial thrombosis in hospitalized COVID-19 patients, we enrolled 20 patients in each arm. Anti-cardiolipin IgG/IgM, beta-2 glycoprotein-1 IgG/IgM, lupus anticoagulant and vitamin D levels were measured in both groups.
RESULTS: Cases were 5.7 times more likely to be vitamin D deficient (OR:5.7, 95% CI:1.3-25.6) and 7.4 times more likely to have any one APLa (OR:7.4, 95% CI: 1.6-49.5) while accounting for the effects of sex. Patients with both APLa and vitamin D deficiency had significantly more thrombosis compared to patients who were antibody positive without vitamin D deficiency (100% vs 47.4%; p = 0.01).
CONCLUSIONS: Thrombosis in COVID-19 was associated with concomitant APLa and vitamin D deficiency. Future studies in COVID-19 should assess the role of vitamin D in reducing thrombosis.
OBJECTIVE: Measure APLa and vitamin D in hospitalized COVID-19 patients with and without thrombosis to evaluate if thromboembolism is associated with concomitant APLa and vitamin D deficiency.
METHODS: Case-control study. Hospitalized COVID-19 patients with a thromboembolic event (ischemic stroke, myocardial infarction, deep venous thrombosis/pulmonary embolism, Cases n = 20). Controls (n = 20): Age, sex-matched without thromboembolic events. Patients with autoimmune disorders, antiphospholipid antibody syndrome, thrombophilia, anticoagulation therapy, prior thromboembolism, chronic kidney disease 3b, 4, end-stage renal disease, and malignancy were excluded. Given the limited current literature on the role of concomitant antiphospholipid antibodies and vitamin D deficiency in causing venous and/or arterial thrombosis in hospitalized COVID-19 patients, we enrolled 20 patients in each arm. Anti-cardiolipin IgG/IgM, beta-2 glycoprotein-1 IgG/IgM, lupus anticoagulant and vitamin D levels were measured in both groups.
RESULTS: Cases were 5.7 times more likely to be vitamin D deficient (OR:5.7, 95% CI:1.3-25.6) and 7.4 times more likely to have any one APLa (OR:7.4, 95% CI: 1.6-49.5) while accounting for the effects of sex. Patients with both APLa and vitamin D deficiency had significantly more thrombosis compared to patients who were antibody positive without vitamin D deficiency (100% vs 47.4%; p = 0.01).
CONCLUSIONS: Thrombosis in COVID-19 was associated with concomitant APLa and vitamin D deficiency. Future studies in COVID-19 should assess the role of vitamin D in reducing thrombosis.
摘要：
2019年冠状病毒病（COVID-19）与血栓栓塞有关。抗磷脂抗体(APLa)是其形成机制之一。维生素D缺乏与抗磷脂抗体综合征的血栓形成有关。
测量有和没有血栓形成的住院COVID-19患者的APLa和维生素D，以评估血栓栓塞是否与合并的APLa和维生素D缺乏有关。
病例对照研究。住院COVID-19患者发生血栓栓塞事件(缺血性卒中，心肌梗塞,深静脉血栓形成/肺栓塞,案例n=20）。对照（n=20）：年龄，性别匹配无血栓栓塞事件。自身免疫性疾病患者，抗磷脂抗体综合征,血栓形成倾向,抗凝治疗,先前的血栓栓塞,慢性肾病3b,4，终末期肾病，恶性肿瘤被排除在外.鉴于目前关于合并抗磷脂抗体和维生素D缺乏在住院COVID-19患者中引起静脉和/或动脉血栓形成的作用的文献有限，我们在每个臂中纳入了20例患者.抗心磷脂IgG/IgM,β-2糖蛋白-1IgG/IgM，检测两组的狼疮抗凝物和维生素D水平.
患者维生素D缺乏的可能性增加了5.7倍（OR：5.7，95％CI：1.3-25.6），患有任何一种APLa的可能性增加了7.4倍（OR：7.4，95％CI：1.6-49.5），同时考虑了性别的影响。与没有维生素D缺乏的抗体阳性患者相比，APLa和维生素D缺乏的患者血栓形成明显增多（100％vs47.4％；p=0.01）。
COVID-19患者血栓形成与APLa和维生素D缺乏相关。COVID-19的未来研究应评估维生素D在减少血栓形成中的作用。
测量有和没有血栓形成的住院COVID-19患者的APLa和维生素D，以评估血栓栓塞是否与合并的APLa和维生素D缺乏有关。
病例对照研究。住院COVID-19患者发生血栓栓塞事件(缺血性卒中，心肌梗塞,深静脉血栓形成/肺栓塞,案例n=20）。对照（n=20）：年龄，性别匹配无血栓栓塞事件。自身免疫性疾病患者，抗磷脂抗体综合征,血栓形成倾向,抗凝治疗,先前的血栓栓塞,慢性肾病3b,4，终末期肾病，恶性肿瘤被排除在外.鉴于目前关于合并抗磷脂抗体和维生素D缺乏在住院COVID-19患者中引起静脉和/或动脉血栓形成的作用的文献有限，我们在每个臂中纳入了20例患者.抗心磷脂IgG/IgM,β-2糖蛋白-1IgG/IgM，检测两组的狼疮抗凝物和维生素D水平.
患者维生素D缺乏的可能性增加了5.7倍（OR：5.7，95％CI：1.3-25.6），患有任何一种APLa的可能性增加了7.4倍（OR：7.4，95％CI：1.6-49.5），同时考虑了性别的影响。与没有维生素D缺乏的抗体阳性患者相比，APLa和维生素D缺乏的患者血栓形成明显增多（100％vs47.4％；p=0.01）。
COVID-19患者血栓形成与APLa和维生素D缺乏相关。COVID-19的未来研究应评估维生素D在减少血栓形成中的作用。
