Article Text

Download PDFPDF
Response to: ‘Presence of anti-phospholipid antibodies in COVID-19: a case series study’ by Amezcua-Guerra et al
  1. Alexis Mathian1,
  2. Marc Pineton De Chambrun2,
  3. Alain Combes2,
  4. Zahir Amoura1
  1. 1 Sorbonne Université, Assistance Publique–Hôpitaux de Paris, Groupement Hospitalier Pitié–Salpêtrière, French National Referral Center for Systemic Lupus Erythematosus, Antiphospholipid Antibody Syndrome and Other Autoimmune Disorders, Service de Médecine Interne 2, Institut E3M, Inserm UMRS, Centre d’Immunologie et des Maladies Infectieuses (CIMI-Paris), Paris, France
  2. 2 Sorbonne Université, Assistance Publique-Hôpitaux de Paris, Groupement Hospitalier Pitié–Salpêtrière, Institut de Cardiométabolisme et Nutrition (ICAN), Service de Médecine Intensive-Réanimation, Inserm UMRS1166, Paris, France
  1. Correspondence to Dr Alexis Mathian, Internal Medicine, University Hospital Pitié Salpêtrière, Paris, France; alexis.mathian{at}

Statistics from

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.

We thank Amezcua-Guerra et al for their interest in our study reporting on the course of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) disease 2019 (COVID-19) in a case series of patients with systemic lupus erythematosus under long-term treatment with hydroxychloroquine.1 2 Complementary to our work, Amezcua-Guerra et al address the issue of anti-phospholipid antibodies (anti-PL abs) during the course of COVID-19. Indeed, despite adequate thromboprophylaxis, COVID-19 is associated with a high rates of venous, as well as arterial, thromboembolic events, in particular in patients hospitalised in an intensive care unit.3–5 This state of hypercoagulation has been linked to an important systemic inflammatory response syndrome, with elevated serum levels of fibrinogen, factor VIII and D-dimers.6 7 Several reports, including the study by Amezcua-Guerra et al 2 have emphasised the high frequency of serum anti-PL abs and lupus anti-coagulant (LA) in a case series of patients with severe COVID-19, however with surprisingly heterogeneous results.

Amezcua-Guerra et al report a high frequency (57%) of both conventional (ie, those included in the antiphospholipid syndrome (APS) classification criteria) and non-conventional anti-PL abs in patients with severe and critical COVID-19, which appear to be associated with a hyperinflammatory state. An association with pulmonary thromboembolism has also been suggested although this concerned only 2 …

View Full Text


  • Handling editor Josef S Smolen

  • Contributors AM, MPDC, AC and ZA wrote the manuscript.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient and public involvement Patients and/or the public were not involved in the design, or conduct, or reporting, or dissemination plans of this research.

  • Provenance and peer review Commissioned; internally peer reviewed.

Linked Articles

  • Correspondence
    Luis M Amezcua-Guerra Gustavo Rojas-Velasco Malinalli Brianza-Padilla Armando Vázquez-Rangel Ricardo Márquez-Velasco Francisco Baranda-Tovar Rashidi Springall Hector Gonzalez-Pacheco Yaneli Juárez-Vicuña Claudia Tavera-Alonso Fausto Sanchez-Muñoz Marisol Hernández-Salas