SARS-CoV-2 infection has been reported to be associated with a positive direct antiglobulin test (DAT). In this study, an analysis of 40 consecutive coronavirus disease 2019 (COVID-19) cases from December 2020 to September 2021 in Japan revealed that patients of 70 years and over were predisposed to a positive DAT. DAT positivity was related to a decrease in the hemoglobin level. Anemia in DAT-positive COVID-19 patients was attributed to hemolysis, which was corroborated by high reticulocyte counts and an increase in the red blood cell distribution width. Human leukocyte antigen (HLA)-DRB1*12:01 and DRB1*12:02 were exclusively found in DAT-positive COVID-19 patients. In silico assays for the Spike protein of SARS-CoV-2 predicted several common core peptides that met the criteria for a B cell epitope and strong binding to both HLA-DRB1*12:01 and DRB1*12:02. Among these peptides, the amino acids sequence TSNFR, which is found within the S1 subunit of SARS-CoV-2 Spike protein, is shared by human blood group antigen Rhesus (Rh) CE polypeptides. In vitro analysis showed that the expression of HLA-DR in CD4 T cells and CD8 T cells from a DAT-positive patient was increased after pulsation with TSNFR-sequence-containing peptides. In summary, positive DAT is related to enhanced anemia and to HLA-DR12 in the Japanese population. A peptide sequence within SARS-CoV-2 Spike protein may act as an epitope for IgG binding to RBCs in DAT-positive COVID-19 patients.
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| http://dx.doi.org/10.1007/s00277-022-04921-9 | DOI Listing |
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Direct antiglobulin test type, red blood cell distribution width, and estimated glomerular filtration rate for early prediction of in-hospital mortality of patients with COVID-19.
Comput Struct Biotechnol J
December 2024
Department of Clinical Laboratory, Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University, 150 Ximen Road, Linhai, Taizhou, Zhejiang Province, China.
Article Synopsis
- The study aimed to explore how COVID-19 correlates with the direct antiglobulin test (DAT) results, focusing on developing a predictive model for in-hospital mortality based on DAT types among patients with COVID-19.
- The analysis involved 502 patients tested for DAT, revealing that those who were DAT-positive had a higher rate of confirmed COVID-19 cases and worse clinical indicators compared to DAT-negative patients.
- Key findings indicated that DAT-positive patients had higher mortality and comorbidity scores, with a predictive model utilizing DAT type, red blood cell distribution width (RDW), and estimated glomerular filtration rate (eGFR) providing significant predictive accuracy for in-hospital mortality risk.
Immunohematological challenges in COVID infected patients.
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Background: Several autoimmune disorders have been reported to be related with COVID infection. In continuation to these autoimmune phenomenon, autoimmune hemolytic anaemia (AIHA) also has been noted in COVID infected patients. The aim of the study was to find out the prevalence of red cell alloimmunization, ABO discrepancy and positive direct antiglobulin test (DAT) results in COVID infected patients hospitalised in a tertiary care centre in North India.
View Article and Find Full Text PDFAn association between a positive direct antiglobulin test and HLA-DR12 in COVID-19.
Ann Hematol
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Department of Blood Transfusion, Fujita Health University Hospital, 1-98 Dengakugakubo, Kutsukake, Toyoake, Aichi, 470-1192, Japan.
SARS-CoV-2 infection has been reported to be associated with a positive direct antiglobulin test (DAT). In this study, an analysis of 40 consecutive coronavirus disease 2019 (COVID-19) cases from December 2020 to September 2021 in Japan revealed that patients of 70 years and over were predisposed to a positive DAT. DAT positivity was related to a decrease in the hemoglobin level.
View Article and Find Full Text PDFIn this issue of , Berzuini et al describe immunoglobulin G (IgG) bound to the red blood cells (RBCs) of patients with COVID-19 and associate this bound IgG with increased RBC transfusion requirements. The intrigue behind these observations is not just the high (46%) direct antiglobulin test (DAT) positivity rate, but also the novel finding that eluates (ie, antibodies stripped from the surface of the reactive RBCs) from these DAT-positive patients react not with standard-reagent RBCs but exclusively with RBCs from DAT-negative COVID-19 patients.
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