Thrombosis with COVID-19

Independent studies show increased thrombosis and pulmonary embolism in COVID-19 patients; Measurement of Cardiolipin and ß2-GP1 supports therapy assessment

Research teams at Hamburg-Eppendorf University Hospital and Beijing Union Medical College Hospital Beijing found that SARS-CoV-2 infections can lead to thrombosis and pulmonary embolism.

In addition to atypical pneumonia, which is directly related to the lung tissue affected by SARS-CoV-2, there are other life-threatening complications that often occur during COVID-19. Researchers at the UKE were able to use post-mortems to show that SARS-CoV-2 infections increasingly led to the formation of blood clots in the leg veins. These can get into the large pulmonary vessels and cause pulmonary embolism with acute cardiovascular failure (Wichmann et al., 2020). Another study in the NEJM (Zhang et al., 2020) describes Covid-19 patients with coagulopathy and antiphospholipid antibodies who also had increased evidence of thrombosis and pulmonary embolism.

Anti-phospholipid syndrome (APS) as a systemic autoimmune disease that can include clinical conditions such as venous and arterial thrombosis, thrombocytopenia, and myocardial infarction. In addition to these clinical manifestations, the continued presence of a unique collection of autoantibodies defines the syndrome.

These autoantibodies target specific phospholipids and phospholipid-binding proteins. Cardiolipin (CL) is the most common of the phospholipids; it is negatively charged and acidic. Furthermore, beta2-glycoprotein 1 (ß2-GP1; = apolipoprotein H) was identified as a natural and essential co-antigen for CL autoantibodies.

In addition to their diagnostic importance, these antibodies cause increased coagulation with a tendency to thrombosis. The measurement of CL and ß2-GP1 supports the individual assessment of the patient’s risk of thrombosis and can influence therapy decisions at an early stage to prevent pulmonary embolism. Both of the above publications mention this laboratory parameter.

With ELISAs from Steffens-Biotec, IgG and / or IgM antibodies can be measured in serum or plasma that are directed against Cardiolipin or ß2-GP1. In order to investigate the connection between SARS-CoV-2 infections and thrombosis and pulmonary embolism in more detail, extensive studies are required, such as the two above. Steffens-Biotec is happy to provide services and products to support and support in-depth randomized studies.


Wichmann, D., Sperhake, J.-P., Lütgehetmann, M., Steurer, S., Edler, C., Heinemann, A., Heinrich, F., Mushumba, H., Kniep, I., Schröder, A.S., et al. (2020). Autopsy Findings and Venous Thromboembolism in Patients With COVID-19: A Prospective Cohort Study. Ann. Intern. Med.

Zhang, Y., Xiao, M., Zhang, S., Xia, P., Cao, W., Jiang, W., Chen, H., Ding, X., Zhao, H., Zhang, H., et al. (2020). Coagulopathy and Antiphospholipid Antibodies in Patients with Covid-19. N. Engl. J. Med. 382, e38.

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