%0 Journal Article
%T Antiphospholipid antibodies and vitamin D deficiency in COVID-19 infection with and without venous or arterial thrombosis: A pilot case-control study.
%A Shah R
%A Mohammed YN
%A Koehler TJ
%A Kaur J
%A Toufeili M
%A Pulipati P
%A Alqaysi A
%A Khan A
%A Khalid M
%A Lee Y
%A Dhillon P
%A Dan AT
%A Kumar N
%A Bowen M
%A Sule AA
%A Krishnamoorthy G
%A Shah R
%A Mohammed YN
%A Koehler TJ
%A Kaur J
%A Toufeili M
%A Pulipati P
%A Alqaysi A
%A Khan A
%A Khalid M
%A Lee Y
%A Dhillon P
%A Dan AT
%A Kumar N
%A Bowen M
%A Sule AA
%A Krishnamoorthy G
%J PLoS One
%V 17
%N 7
%D 2022
%M 35834511
%F 3.752
%R 10.1371/journal.pone.0269466
%X 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.