Prevalence of autoantibody responses in acute coronavirus disease 2019 (COVID-19)

• Published in: Journal of translational autoimmunity (Online) Vol. 3; p. 100073
• Main Authors: Lerma, L. Angelica, Chaudhary, Anu, Bryan, Andrew, Morishima, Chihiro, Wener, Mark H., Fink, Susan L.
• Format: Journal Article
• Language: English
• Published: Elsevier B.V 01.01.2020; Elsevier
• Subjects: Antinuclear antibody; Antiphospholipid antibody; Autoantibody; COVID-19; SARS-CoV-2; Short communication; COVID-19; Autoantibody; SARS-CoV-2; Antiphospholipid antibody; Antinuclear antibody
• DOI: 10.1016/j.jtauto.2020.100073
• ISSN: 2589-9090

Immunopathology may play a significant role in the pathogenesis of Coronavirus-Induced Disease-19 (COVID-19). Immune-mediated tissue damage could result from development of rapid autoimmune responses, characterized by production of self-reactive autoantibodies. In this study, we tested specimens from acutely ill patients hospitalized with COVID-19 for autoantibodies against nuclear, vasculitis-associated, and phospholipid antigens. Detectable autoantibodies were present in 30% of the patients in our cohort, with the majority of reactive specimens demonstrating antibodies to nuclear antigens. However, antinuclear antibodies were only weakly reactive and directed to single antigens, as is often seen during acute infection. We identified strongly reactive antibodies to nuclear antigens only in patients with a prior history of autoimmune disease. In our cohort, the prevalence of antiphospholipid antibodies was low, and we did not detect any vasculitis-associated autoantibodies. We found similar levels of inflammatory markers and total immunoglobulin levels in autoantibody positive versus negative patients, but anti-SARS-CoV-2 antibody levels were increased in autoantibody positive patients. Together, our results suggest that acute COVID-19 is not associated with a high prevalence of clinically significant autoantibody responses of the type usually associated with autoimmune rheumatic disease. •Autoantibodies against nuclear antigens are detectable in 25% of patients hospitalized with acute COVID-19.•Anti-nuclear antigen antibodies were weakly reactive and most often directed to single antigens.•Vasculitis-associated autoantibodies were not detected in specimens from patients with acute COVID-19.•Anti-phospholipid antibodies were infrequently detected in patients with acute COVID-19.