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A Covid-19 Patient with Complement-Mediated Coagulopathy and Severe Thrombosis

Christopher R. ShowersDepartment of Medicine, New York-Presbyterian Queens, Weill Cornell Medicine, New York, New York, USA, [email protected]Gerard J. NuovoDiscovery Life Sciences, Powell, Ohio, USAAmit LakhanpalDivision of Rheumatology, Hospital for Special Surgery, Weill Cornell Medicine, New York, New York, USACaroline H. SiegelDivision of Rheumatology, Hospital for Special Surgery, Weill Cornell Medicine, New York, New York, USAJuliet AizerDivision of Rheumatology, Hospital for Special Surgery, Weill Cornell Medicine, New York, New York, USALauren ElredaDivision of Hematology/Oncology, Department of Medicine, New York-Presbyterian Queens, Weill Cornell Medicine, New York, New York, USAAlexandra HaleviDepartment of Surgery, New York-Presbyterian Queens, Weill Cornell Medicine, New York, New York, USAAndrew LaiDivision of Hospital Medicine, Department of Medicine, University of California San Francisco, San Francisco, California, USADoruk ErkanBarbara Volcker Center for Women and Rheumatic Disease, Hospital for Special Surgery, Weill Cornell Medicine, New York, New York, USACynthia M. MagroDepartment of Pathology and Laboratory Medicine, Weill Cornell Medicine, New York, New York, USA

2020en

ABI

Annotatsiya

We report a patient with severe Covid-19-associated coagulopathy and type 2 diabetes mellitus who tested positive for antiphospholipid antibodies (aPL). Analysis of skin specimens suggested direct SARS-CoV-2 viral-induced and complement-mediated vascular injury and thrombosis, consistent with prior reports. Serial aPL testing demonstrated high levels of anticardiolipin antibodies (aCL) that declined to insignificant levels over a period of 5 weeks. SARS-CoV-2 RNA was detected in nasopharyngeal swab specimens on serial assays performed over the same 5-week period, though it was not detected thereafter. We hypothesize that SARS-CoV-2 viral-induced aPL contributed to severe Covid-19-associated coagulopathy in this patient.

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DOI: 10.1159/000512503

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