"True" Antiphospholipid Syndrome in COVID-19: Contribution of the Follow-up of Antiphospholipid Autoantibodies

COVID-19 has led to more than 5 million deaths to date.[1] COVID-19 presentation can range from a simple asymptomatic viral infection to acute respiratory distress syndrome (ARDS)[2]; 15 to 20% of patients develop severe pneumonia and experience coagulopathy disorders. Severe COVID-19 occurs in the context of hyperinflammation that could potentially generate autoimmune disease.[3] We and others have shown the presence of antiphospholipid (aPL) autoantibodies in patients with COVID-19.[4] However, there remains contention if these aPLs represent transient antibodies associated with infection, or “true” aPL reflective of potential autoimmune-associated coagulopathy, namely, antiphospholipid syndrome (APS).[5] [6] Thus, only if they can be shown to persist for at least 12 weeks, can they be considered essential markers for the diagnosis of APS.[7] [8]