LitCovid-sentences  

PMC:7289100 / 10989-17645 JSONTXT 12 Projects

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Id Subject Object Predicate Lexical cue
T73 0-67 Sentence denotes 6 Antiphospholipid antibodies and thrombosis secondary to COVID-19
T74 68-196 Sentence denotes Deep vein thrombosis, pulmonary embolism and stroke have been observed in patients affected by severe forms of COVID-19 [40,41].
T75 197-288 Sentence denotes These vascular events, particularly strokes, were mostly recorded in elderly patients [41].
T76 289-379 Sentence denotes However, 5 cases of stroke were recently reported in relatively young patients (age range:
T77 380-485 Sentence denotes 33–49 years), in association with prolonged activated partial-thromboplastin time (aPTT) in 2 cases [42].
T78 486-749 Sentence denotes Vascular manifestations of COVID-19 comprise either venous or arterial thrombosis or stroke in subjects under the age of 50, sometimes with a severe phenotype that can resemble the “catastrophic” clinical picture associated with antiphospholipid antibodies (aPL).
T79 750-1182 Sentence denotes In patients with systemic autoimmune diseases such as Systemic Lupus Erythematosus (SLE), aPL represent the major cause of thrombosis (either arterial or venous or microangiopathic) and pregnancy morbidity. aPL are pathogenic autoantibodies that can cause the same vascular and obstetric manifestations also in subjects without any other autoimmune disease, suffering from the so called Primary Antiphospholipid Syndrome (APS) [43].
T80 1183-1423 Sentence denotes The more severe form of APS (the “catastrophic” APS, CAPS) is characterized by a rapidly occurring multiorgan thrombotic damage with histopathological evidence of microangiopathy [44], recalling pictures described in patients with COVID-19.
T81 1424-1532 Sentence denotes CAPS is usually preceded by a precipitating factor, which is an infection in the majority of the cases [45].
T82 1533-1788 Sentence denotes The link between infection and aPL was first observed when patients with different autoimmune conditions were found to be positive for the serological test of syphilis, whose antigen was described as a mixture of phospholipids, including cardiolipin [46].
T83 1789-2052 Sentence denotes Nowadays, the detection of aPL is performed by anticardiolipin (aCL) and anti-beta2glicoprotein I (anti-b2GPI) immunoassays and by the functional coagulation test lupus anticoagulant (LA), according to the international consensus APS classification criteria [47].
T84 2053-2179 Sentence denotes Three cases of COVID-19 patients with severe thrombotic events associated with aCL and anti-b2GPI were recently reported [48].
T85 2180-2390 Sentence denotes Specifically, aCL of IgA isotype and anti-b2GPI of IgG and IgA isotype were detected, raising the hypothesis that the mucosal damage induced by SARS-CoV-2 could preferentially stimulate the IgA immune response.
T86 2391-2439 Sentence denotes LA was found to be negative in these 3 patients.
T87 2440-2609 Sentence denotes On the other hand, LA was found to be positive in 25 out of 56 (44.6%) consecutive COVID-19 patients, while IgG/IgM aCL and/or anti-b2GPI were positive only in 5 (8.9%).
T88 2610-2681 Sentence denotes No specific relation with thrombosis was mentioned in this cohort [49].
T89 2682-2799 Sentence denotes In addition, LA was studied in patients with prolonged aPTT, a finding that has been frequently reported in COVID-19.
T90 2800-2926 Sentence denotes More than 90% of patients with prolonged aPTT, with or without clinical evidence of thrombosis, resulted positive for LA [50].
T91 2927-3043 Sentence denotes Another study investigated patients with acute respiratory distress syndrome and COVID-19 from intensive care units.
T92 3044-3235 Sentence denotes In this study, 50 out of 59 (84.7%) tested patients had LA positive, strongly associated with high D-dimers and thrombosis, particularly if the test was performed early in the disease course.
T93 3236-3305 Sentence denotes In this series only one patient had positive aCL of IgM isotype [51].
T94 3306-3405 Sentence denotes Therefore, we can assume that aPL can be frequently detected in patients with SARS-CoV-2 infection.
T95 3406-3453 Sentence denotes Certainly, this finding is not surprising [52].
T96 3454-3720 Sentence denotes In fact, the occurrence of transient aPL was described in patients affected by several viral infections such as human immunodeficiency virus (HIV), varicella zoster, hepatitis C virus, cytomegalovirus (CMV), Epstein–Barr virus (EBV), adenovirus, parvovirus B19 [53].
T97 3721-3912 Sentence denotes In addition, aPL were also detected in patients with infections of different origin (bacterial, parasitic, etc) and an infection was often reported just before the clinical onset of APS [54].
T98 3913-4151 Sentence denotes These observations suggest the possible existence of molecular mimicry due to similarity between the peptide regions identified in the b2GPI molecule (and recognized by anti-b2GPI) and membrane proteins of several virus and bacteria [55].
T99 4152-4343 Sentence denotes Animals immunized with different viruses or bacteria (or proteins derived from them) developed anti-b2GPI antibodies that in some cases were associated with the occurrence of thrombosis [56].
T100 4344-4496 Sentence denotes The different pathogenic potential of antibodies can be attributed to the fine specificity that they acquire after immunization with different antigens.
T101 4497-4788 Sentence denotes It is in fact known that antibodies directed to domain 1 of the b2GPI molecule are associated with an increased risk of thrombosis (in systemic autoimmune diseases and APS) [57] while antibodies directed to other parts of the molecule, such as domain 4/5, can be regarded as “innocent” [58].
T102 4789-5055 Sentence denotes On the other hand, the features of the host can also be important, since genetic background is recognized as one of the determinant factors in the induction of autoimmunity and can be the driver which turns aPL from being transient to persistent and pathogenic [59].
T103 5056-5236 Sentence denotes The above considerations widely justify why aPL, detected with different assays, can be found in patients affected by COVID-19, sometimes associated with thrombosis but not always.
T104 5237-5477 Sentence denotes To our knowledge, no increased rate of miscarriages or fetal loss have been reported during SARS-CoV-2 pandemic so far, although some severe pregnancy complication, like those linked to aPL, such as HELLP syndrome were occasionally seen (A.
T105 5478-5512 Sentence denotes Lojacono, personal communication).
T106 5513-5684 Sentence denotes Whether pregnant women with COVID-19 have an increased rate of positive aPL during pregnancy is not known yet nor it is defined their possible impact on pregnancy outcome.
T107 5685-5724 Sentence denotes COVID-19 is a novel infectious disease.
T108 5725-5810 Sentence denotes The true relationship between this infection and aPL need to be further investigated.
T109 5811-6018 Sentence denotes However, according to the “second hit hypothesis” [60], the thrombogenic potential of aPL is magnified in the presence of an infection or a severe inflammatory state, which is often associated with COVID-19.
T110 6019-6245 Sentence denotes Therefore, the search for aPL may be considered in the management of COVID-19 patients with vascular manifestations, as the detection of positive aPL would allow of the indication for an early adequate anticoagulant treatment.
T111 6246-6436 Sentence denotes In the case of aPL positivity, a follow-up testing after at least 12 weeks is warranted, in order to verify the persistence of aPL, which would suggest the post-infectious occurrence of APS.
T112 6437-6656 Sentence denotes In fact, APS is currently considered as a systemic autoimmune disease which is not limited to thrombosis and pregnancy morbidity and deserves specific long-term management including anticoagulation and immunomodulation.