This is all anecdotal (i.e. my experience), but it may be of interest. I have primary APS (stroke, DVT, kidney clots, cerebral infarcts). INR = 3-4 + hydroxychloroquine.
I got coronavirus (confirmed test result). Admitted into hospital following seizures, high temp >100, breathing difficulties, low blood oxygen.
And there I spent 12 days on oxygen, with a few days touch and go when it got quite serious. I'm not going to sugarcoat it. I've had extended stays in hospital before, but this was the worst experience of my life. I saw people traumatised. I saw grown men asking to die (by stopping the oxygen supply). I saw people physically fighting their hallucinations. Nurses were superb with a high ratio of nurses to patients. The ward, hospital, and doctors did not seem to be under added pressure, and there was a friendly, relaxed, atmosphere on the ward from the staff.
When the disease gets going, it's very, very tough. It's like drowning. And your muscles go. You can't even stand. I went 8 days without eating, due to loss of appetite. And would have a fit every time my temperature climbed too high. Everyone seemed to be clotting, as everyone was being injected with heparin.
More relevant to APS patients is perhaps the craziness of my INR. Usually, I'm on 11 mg of Warfarin. They took me down to 3 mg and INR continued to climb to 6. The anticoagulant team at the hospital really struggled to get it under control. I had a venous test daily.
Even when my INR was fairly high at 6, I was still injected with clexane/heparin. I do think being well anti coagulated before admittance, my INR going higher than it should, and the clexane helped a great deal, even though my risk of a bleed must have been high. Even now my INR is fluctuating wildly from 1.2 to 6 in the space of a few days, despite monitoring from the anticoagulation nurses in Haematology 2-3 times a week. This is highly unusual for me.
I got discharged after 12 days. Before the illness I could run 5 km. I lifted heavy weights at the gym three times a week. Yet I left in a wheelchair. Couldn't even walk from the ward to the elevator. Once at home, I needed bed rest for 23 hours a day. It just wipes you. Was unable to talk due to weak lungs.
Note: If you have APS and are on blood thinners, then they do not test for pulmonary embolism within the NHS when admitted with coronavirus. I asked why. The response was that the treatment would not change whether you have a PE or not. So the docs *think* I had clots in my lungs, but there is no confirmation. Non- APS docs were not interested in APS in the slightest.
I'm now in week 9, since onset of symptoms. Recovery is quite slow. Apart from the back garden, I haven't been outside or walked for 8 weeks. Muscle strength starts to return after about 6 weeks.
I got told that antibodies to the disease take 2-8 weeks to form after symptoms have stopped, and therefore to be extra cautious during this time.
At week 6, my exercise bike arrived, and I started building up my leg muscles and lung capacity. It really has helped a lot. Can highly recommend.
I am convinced, this is just my opinion, take it or leave it, that hydroxychloroquine has helped speed my recovery. Perhaps via reducing inflammation, but who knows.
The upshot is, as far as I'm concerned, if you have APS, whether we are classed as a vulnerable group or not, take coronavirus seriously. We may not be at higher risk of catching it like our cousins with Lupus, but given we clot and get inflamed under normal circumstances, when I did get it, then it struck real hard -- and my APS was really well controlled at the time.
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