J Am Heart Assoc. 2020 Sep 25:e017773. doi: 10.1161/JAHA.120.017773. Online ahead of print.
Background Recent literature reports a strong thrombotic tendency in patients hospitalized for a Covid-19 infection. This characteristic is quite 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 their 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 protein S deficiency and a very high ie.: 72% prevalence of antiphospholipid antibodies: mainly lupus anticoagulant. The presence of PS deficiency or antiphospholipid antibodies was not linked with a prolonged aPTT nor with D-dimer, fibrinogen or 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 disease and should not systematically modify our strategy on prophylactic anticoagulant treatment which is already revised upwards in this pathology.