A Covid-19 Patient with Complement-Mediated Coagulopathy and Severe Thrombosis
Christopher R. Showers, Gerard J. Nuovo, Amit Lakhanpal, Caroline H. Siegel, Juliet Aizer, Lauren Elreda, Alexandra Halevi, Andrew Lai, Doruk Erkan, Cynthia M. Magro
Abstract
We report a patient with severe Covid-19-associated coagulopathy and type 2 diabetes mellitus who tested positive for antiphospholipid antibodies (aPL). Analysis of skin specimens suggested direct SARS-CoV-2 viral-induced and complement-mediated vascular injury and thrombosis, consistent with prior reports. Serial aPL testing demonstrated high levels of anticardiolipin antibodies (aCL) that declined to insignificant levels over a period of 5 weeks. SARS-CoV-2 RNA was detected in nasopharyngeal swab specimens on serial assays performed over the same 5-week period, though it was not detected thereafter. We hypothesize that SARS-CoV-2 viral-induced aPL contributed to severe Covid-19-associated coagulopathy in this patient.