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  • Response to: Correspondence on ‘Anticardiolipin and other antiphospholipid antibodies in critically ill COVID-19 positive and negative patients’ by Liu

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Correspondence response
Response to: Correspondence on ‘Anticardiolipin and other antiphospholipid antibodies in critically ill COVID-19 positive and negative patients’ by Liu
  1. Marvin J Fritzler1,
  2. Uriel Trahtemberg2
  3. on behalf of the COVID-19 Longitudinal Biomarkers of Lung Injury (COLOBILI) study group
  1. 1 Medicine, University of Calgary Cumming School of Medicine, Calgary, Alberta, Canada
  2. 2 Critical Care, St Michael's Hospital, Toronto, Ontario, Canada
  1. Correspondence to Professor Marvin J Fritzler, Medicine, University of Calgary Cumming School of Medicine, Calgary, Canada; fritzler{at}ucalgary.ca

http://dx.doi.org/10.1136/annrheumdis-2021-221780

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    We thank Dr Yudong Liu1 for commenting on our manuscript and on many of the same issues we raised.2 There are, however, some comments that require clarification and a response. It is true that antiphospholipid antibodies (aPLs) of various specificities and immunoglobulin isotypes have been reported in COVID-19.3 However, despite a historical connection of aPLs with coagulopathies and antiphospholipid syndrome (APS), to date there has been no convincing evidence that aPLs has this in vivo pathogenic effect in COVID-19. In our patients, despite the presence of aPLs (eg, IgG anticardiolipin), there was no link to thrombotic events, a finding echoed by other referenced studies4 and recently reviewed.3 5 The recent publication by Chang et al 6 is mentioned, but it is important to appreciate that their results were compared with ‘normal’ controls and no clinical features (coagulopathy or APS) were reported, precluding any inferences to …

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    Footnotes

    • Handling editor Josef S Smolen

    • Collaborators COVID-19 Longitudinal Biomarkers of Lung Injury (COLOBILI) study group, University of Toronto. Robert Rottapel2,3; Claudia C dos Santos1,4,5; Arthur S. Slutsky4,5; Andrew J Baker1,4,5

      1. Critical Care Department, St. Michael’s Hospital, Toronto, ON, Canada.

      2. Departments of Medicine and Immunology, University of Toronto, Toronto, ON, Canada.

      3. Division of Rheumatology, St. Michael’s Hospital, Toronto, ON, Canada.

      4. Keenan Centre for Biomedical Research, Li Ka Shing Knowledge Institute, St. Michael’s Hospital, Toronto, ON, Canada.

      5. Interdepartmental Division of Critical Care Medicine, University of Toronto, Toronto, ON, Canada

    • Contributors Both authors contributed to and edited the response 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.

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