Introduction: Among various proposed pathologic mechanisms during the coronavirus disease 2019 (COVID-19) pandemic, overproduction of autoantibodies is not widely studied. Antiphospholipid antibodies (aPLs), target proteins with an affinity toward charged phospholipids, are thought to have pro-thrombotic potentials and are mainly elevated during thromboembolism. The present systematic review and meta-analysis aimed to evaluate the relationship between serum aPLs level and COVID-19 mortality, severity, and thrombotic events.
Material and methods: We designed our search strategy to evaluate all open access published articles in Medline, Scopus and Google Scholar. Studies evaluating individuals older than 18 years of age who were diagnosed with COVID-19 and reported to have positive aPLs results; and provided data on mortality or thrombotic events were included.
Results: Five hundred and twelve articles identified according to the study search protocol and twenty-two studies were finally included. A total of Among the entire study population in 22 studies, 1462 patients were evaluated for aPLs and the prevalence of positive was 48.1%. Among 372 patients with positive aPLs, 156 patients (41.9%) had severe disease and aPLs positivity was related to severe disease (p<0.05). Also, a hundred and forty-eight out of 561 patients (26.3%) with positive aPLs developed thrombotic events and aPLs positivity was related to the development of thrombotic events (p=0.03). Moreover, aPLs positivity was related to anytime mortality in COVID-19 patients (p=0.01).
Conclusion: The present review demonstrated that aPLs are linked to COVID-19 severity and thrombotic events but not short-term mortality. Further studies with longer follow up periods are warranted.