Pre-existing Autoantibodies Neutralizing High Concentrations of Type I Interferons in Almost 10% of COVID-19 Patients Admitted to Intensive Care in Barcelona.

Abstract

BACKGROUND:

It is important to predict which patients infected by SARS-CoV-2 are at higher risk of life-threatening COVID-19. Several studies suggest that neutralizing auto-antibodies (auto-Abs) against type I interferons (IFNs) are predictive of critical COVID-19 pneumonia.

OBJECTIVES:

We aimed to test for auto-Abs to type I IFN and describe the main characteristics of COVID-19 patients admitted to intensive care depending on whether or not these auto-Abs are present.

METHODS:

Retrospective analysis of all COVID-19 patients admitted to an intensive care unit (ICU) in whom samples were available, from March 2020 to March 2021, in Barcelona, Spain.

RESULTS:

A total of 275 (70.5%) out of 390 patients admitted to ICU were tested for type I IFNs auto-antibodies (α2 and/or ω) by ELISA, being positive in 49 (17.8%) of them. Blocking activity of plasma diluted 1/10 for high concentrations (10 ng/mL) of IFNs was proven in 26 (9.5%) patients. Almost all the patients with neutralizing auto-Abs were men (92.3%). ICU patients with positive results for neutralizing IFNs auto-Abs did not show relevant differences in demographic, comorbidities, clinical features, and mortality, when compared with those with negative results. Nevertheless, some laboratory tests (leukocytosis, neutrophilia, thrombocytosis) related with COVID-19 severity, as well as acute kidney injury (17 [65.4%] vs. 100 [40.2%]; p = 0.013) were significantly higher in patients with auto-Abs.

CONCLUSION:

Auto-Abs neutralizing high concentrations of type I IFNs were found in 9.5% of patients admitted to the ICU for COVID-19 pneumonia in a hospital in Barcelona. These auto-Abs should be tested early upon diagnosis of SARS-CoV-2 infection, as they account for a significant proportion of life-threatening cases.

• Authors: Xavier Solanich, Raúl Rigo-Bonnin, Victor-David Gumucio, Paul Bastard, Jérémie Rosain, Quentin Philippot, Xosé-Luis Perez-Fernandez, Maria-Paz Fuset-Cabanes, Miguel-Ángel Gordillo-Benitez, Guillermo Suarez-Cuartin, Enric Boza-Hernandez, Antoni Riera-Mestre, Alba Parra-Martínez, Roger Colobran, Arnau Antolí, Sergio Navarro, Gemma Rocamora-Blanch, Mario Framil, Laura Calatayud, Xavier Corbella, Jean-Laurent Casanova, Francisco Morandeira, Joan Sabater-Riera
• Journal: Journal of clinical immunology (J Clin Immunol) Vol. 41 Issue 8 Pg. 1733-1744 (11 2021) ISSN: 1573-2592 [Electronic] Netherlands
• PMID: 34570326 (Publication Type: Journal Article, Research Support, N.I.H., Extramural, Research Support, Non-U.S. Gov't)
• Copyright: © 2021. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.

Chemical References

• Antibodies, Neutralizing
• Autoantibodies
• Interferon Type I

Topics

• Aged
• Antibodies, Neutralizing (blood)
• Autoantibodies (blood)
• COVID-19 (immunology)
• Female
• Humans
• Intensive Care Units
• Interferon Type I (immunology)
• Male
• Middle Aged
• Retrospective Studies
• SARS-CoV-2