key: cord-0973530-0b1dbz6q authors: Devaux, Christian A.; Camoin-Jau, Laurence; Mege, Jean-Louis; Raoult, Didier title: Can hydroxychloroquine be protective against COVID-19-associated thrombotic events ? date: 2021-01-05 journal: J Microbiol Immunol Infect DOI: 10.1016/j.jmii.2020.12.010 sha: fa38f19c5d065743ab40347c35c727080fc05c52 doc_id: 973530 cord_uid: 0b1dbz6q Although SARS-CoV-2 is considered a lung-tropic virus, severe COVID-19 is not just a viral pulmonary infection, clinically it is a multi-organ pathology with major coagulation abnormalities and thromboembolism events. Recently, antiphospholipid (aPL) antibodies were found increased in a large number of COVID-19 patients. Elevated aPL have been well documented in antiphospholipid syndrome (APS), a systemic autoimmune disorder characterized by recurrent venous or arterial thrombosis and/or obstetrical morbidity. Among treatment regimen of APS, hydroxychloroquine (HCQ) is one of the molecules proposed in the primary prevention of thrombosis and obstetrical morbidity in those patients. Due to its antithrombotic properties documented in APS therapy, HCQ could be considered a good candidate for the prevention of thrombotic events in COVID-19 patients in association with anticoagulant and its repurposing deserves further evaluation. diagnosis is limited to end stage of COVID-19. Yet, this disorder is not a typical DIC fibrinogen levels are often high and platelets are rarely reduced. It is more similar to 154 complement mediated thrombotic microangiopathy (TMA) syndromes, that is involve In parallel to these observations, it is important to underline the fact that a high prevalence of 174 antiphospholipid (aPL) antibodies has been observed in critical COVID-19 patients and is Hydroxychloroquine as an anti-thrombotic in antiphospolipid syndrome Long-term 636 use of hydroxychloroquine reduces antiphospholipid antibodies levels in patients with 637 primary antiphospholipid syndrome What is the role of hydroxychloroquine in reducing thrombotic risk in 639 patients with antiphospholipid antibodies? Clinical course of high-risk patients 642 diagnosed with antiphospholipid syndrome Does hydroxychloroquine sulfate prevent clot formation in systemic lupus 644 erythematosus ? Hydroxychloroquine and postoperative thromboembolism after total hip 646 replacement On the inhibitory effect of chloroquine on blood 648 platelet aggregation Hydroxychloroquine reverses thrombogenic properties of antiphospholipid antibodies in mice Hydroxychloroquine reverses the prothrombotic state in a mouse model of antiphospholipid 654 syndrome: role of reduced inflammation and endothelial dysfunction A cross-sectional 657 study of clinical thrombotic risk factors and preventive treatments in antiphospholipid 658 syndrome Systemic lupus 660 erythematosus in a multicentric cohort (LUMINA): XXVIII. Factor predictive of thrombotic 661 event APS ACTION-AntiPhospholipid Syndrome Alliance for Clinical 104. Metjian A, Lim W. ASH evidence-based guidelines: should asymptomatic patients with 668 antiphospholipid antibodies receive primary prophylaxis to prevent thrombosis? Effect of antimalarials on thrombosis and survival in patients with systemic lupus 672 erythematosus The protective 674 effect of antimalarial drug on thrombovascular events in systemic lupus erythematosus Hydroxychloroquine reverse 677 platelet activation induced by human IgG antiphospholipid antibodies Hydroxychloroquine 680 directly reduces the binding of antiphospholipid antibody-beta2-glycoprotein I complexes to 681 phospholipid bilayers Hydroxychloroquine protect the annexin A5 anticoagulant shield from disruption by 684 antiphospholipid antibodies: evidence for a novel effect for an old anti-malarial drug hydroxychloroquine versus placebo in addition to standard treatment in pregnant women with 704 antiphospholipid syndrome or antibodies HIBISCUS: hydroxychloroquine for the secondary prevention of thrombotic and obstetrical 707 events in primary antiphospholipid syndrome Study of the role of 709 hydroxychloroquine in immunomodulation and control of hypercoagulatbility in patients 710 diagnosed with primary antiphospholipid syndrome The effect of 712 hydroxychloroquine on thrombosis prevention and antiphospholipid syndrome: a pilot open 713 label randomized prospective study Hydroxychloroquine and COVID-19: 715 a cellular and molecular biology based update Coagulopathy of COVID-19 and 717 antiphospholipid antibodies Clinical course of coronavirus disease 2019 (COVID-19) in a series of 17 patients with 720 systematic lupus erythematosus under long-term treatment with hydroxychloroquine Natural 723 history of COVID-19 and therapeutic options