Antibody Triggers Blood Clots in Severe COVID-19

An autoimmune antibody circulating in the blood is responsible for triggering blood clots in people with severe COVID-19 infection. This antibody attacks cells and causes blood clots n arteries, veins, and other microscopic vessels. In COVID-19 patients, blood clots restrict blood flow to the lungs and impair oxygen exchange.

The clot-causing antibodies are usually seen in patients who have an autoimmune condition called antiphospholid syndrome. According to study co-corresponding author Yogen Kanthi, M.D., an assistant professor at the Michigan Medicine Frankel Cardiovascular Center and a Lasker Investigator at the National Institutes of Health's National Heart, Lung, and Blood Institute, the connection between COVID-19 and autoantibodies was unexpected.

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‘COVID-19 infection triggers the production of autoimmune antibodies that circulate through the blood, producing clots in people suffering from severe infection’
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Blood clots can cause life-threatening events like strokes.

"In patients with COVID-19, we continue to see a relentless, self-amplifying cycle of inflammation and clotting in the body," Kanthi says. "Now we're learning that autoantibodies could be a culprit in this loop of clotting and inflammation that makes people who were already struggling even sicker."

The study is published in the new Science Translational Medicine.

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Around half of the patients sick with severe COVID-19 exhibited a combination of high levels of both the dangerous antibodies and super-activated neutrophils, which are destructive, exploding white blood cells.

Examining mice models revealed that this lethal combination of explosive neutrophils and the COVID-19 antibodies is behind the clots.

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"Antibodies from patients with active COVID-19 infection created a striking amount of clotting in animals - some of the worst clotting we've ever seen," Kanthi says. "We've discovered a new mechanism by which patients with COVID-19 may develop blood clots."

Researchers are testing to see if patients with a high level of these antibodies would benefit from blocking or removing the antibodies. If removing antibodies is found to be effective, then aggressive treatments like plasmapheresis may be necessary.

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Plasmapheresis involves draining blood through an IV, filtering it, and replacing it with fresh plasma that does not contain those antibodies associated with blood clots.

The researchers are also currently running a randomized clinical trial called DICER, which is testing a well-known anti-clotting agent, dipyridamole, in patients with COVID-19 to determine whether it's more effective than a placebo in reducing excessive blood clots.

'Dipyridamole is an old drug that is safe, inexpensive, and scalable," Kanthi says. "The FDA approved it 20 years ago to prevent clotting, but we only recently discovered its potential to block this specific type of inflammation that occurs in COVID."

Source-Medindia