Arthritis Rheumatol. 2020 Jul 31. doi: 10.1002/art.41472. Online ahead of print.
Thromboses are severe complications of the coronavirus disease 2019 (COVID-19) caused by the novel severe acute respiratory system coronavirus 2 (SARS-CoV-2). The mechanism of COVID-19-associated thrombophilia is unknown; increasing global reports of antiphospholipid antibody (aPL)-positivity in COVID-19 suggest that the virus may induce antiphospholipid syndrome (APS), a separate autoimmune thrombotic illness1. Because laboratory criteria used to diagnose APS are neither strongly specific nor sensitive, and because clinical circumstances including anticoagulation alter the laboratory results, international committees have published strict guidelines for aPL testing2,3. The hypothesis that SARS-CoV-2 induces APS requires demonstration that COVID-19 patients fulfill both the clinical and the laboratory criteria for APS4. We reviewed recent publications (Supplementary Material for Methods) in order to assess the likelihood that aPL contribute to thromboses in COVID-19 patients.