High Prevalence of Acquired Thrombophilia Without Prognosis Value in Patients With Coronavirus Disease 2019

Emile Ferrari, Benjamin Sartre, Fabien Squara, Julie Contenti, Celine Occelli, Fabien Lemoel, Jacques Levraut, Denis Doyen, Jean Dellamonica, Veronique Mondain, David Chirio, Karine Risso, Eric Cua, Jean Christophe Orban, Carole Ichai, Mohamed Labbaoui, Baptiste Mossaz, Pamela Moceri, Anny Appert-Flory, Florence Fischer, Pierre Toulon, Emile Ferrari, Benjamin Sartre, Fabien Squara, Julie Contenti, Celine Occelli, Fabien Lemoel, Jacques Levraut, Denis Doyen, Jean Dellamonica, Veronique Mondain, David Chirio, Karine Risso, Eric Cua, Jean Christophe Orban, Carole Ichai, Mohamed Labbaoui, Baptiste Mossaz, Pamela Moceri, Anny Appert-Flory, Florence Fischer, Pierre Toulon

Abstract

Background Recent literature reports a strong thrombotic tendency in patients hospitalized for a coronavirus disease 2019 (COVID-19) infection. This characteristic is unusual and seems specific to COVID-19 infections, especially in their severe form. Viral infections can trigger acquired thrombophilia, which can then lead to thrombotic complications. We investigate for the presence of acquired thrombophilia, which could participate in this phenomenon, and report its prevalence. We also wonder if these thrombophilias participate in the bad prognosis of severe COVID-19 infections. Methods and Results In 89 consecutive patients hospitalized for COVID-19 infection, we found a 20% prevalence of PS (protein S) deficiency and a high (ie, 72%) prevalence of antiphospholipid antibodies: mainly lupus anticoagulant. The presence of PS deficiency or antiphospholipid antibodies was not linked with a prolonged activated partial thromboplastin time nor with D-dimer, fibrinogen, or CRP (C-reactive protein) concentrations. These coagulation abnormalities are also not linked with thrombotic clinical events occurring during hospitalization nor with mortality. Conclusions We assess a high prevalence of positive tests detecting thrombophilia in COVID-19 infections. However, in our series, these acquired thrombophilias are not correlated with the severity of the disease nor with the occurrence of thrombotic events. Albeit the strong thrombotic tendency in COVID-19 infections, the presence of frequent acquired thrombophilia may be part of the inflammation storm of COVID-19 and should not systematically modify our strategy on prophylactic anticoagulant treatment, which is already revised upwards in this pathological condition. Registration URL: https://www.clini​caltr​ials.gov; Unique identifier: NCT04335162.

Keywords: coronavirus disease 2019; thrombophilia; thrombosis.

Conflict of interest statement

None.

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