COVID-19 and Immunological Dysregulation: Can Autoantibodies be Useful?
COVID-19 and Immunological Dysregulation: Can Autoantibodies be Useful?
复制标题
DOI：
10.1111/cts.12908
复制
发表时间：
2021-03
期刊：
影响因子：
--
通讯作者：
Muratori P
中科院分区：
文献类型：
--
作者：
Pascolini S;Vannini A;Deleonardi G;Ciordinik M;Sensoli A;Carletti I;Veronesi L;Ricci C;Pronesti A;Mazzanti L;Grondona A;Silvestri T;Zanuso S;Mazzolini M;Lalanne C;Quarneti C;Fusconi M;Giostra F;Granito A;Muratori L;Lenzi M;Muratori P
冠状病毒病2019(新冠肺炎)常与间质性肺炎有关。然而，由于对新冠肺炎患者自身免疫血清标志物的存在知之甚少，我们分析了新冠肺炎相关肺炎患者自身抗体的存在及其作用。我们前瞻性地研究了连续33例新冠肺炎患者，其中31例(94%)为间质性肺炎，25例年龄匹配和性别匹配的发热和/或肺炎患者作为病理对照组。对所有患者进行抗核抗体(ANA)、抗磷脂抗体和抗中性粒细胞抗体(ANCA)检测。还收集了临床、生化和放射学参数。在33例患者中，15例(45%)至少一种自身抗体检测阳性，其中11例ANAS检测阳性(33%)，8例抗心磷脂抗体检测阳性(免疫球蛋白G和/或免疫球蛋白；24%)，3例抗β2-糖蛋白抗体检测阳性(免疫球蛋白和/或免疫球蛋白抗体9%)。所有患者均未检测到ANCA反应性。自身抗体检测阳性的患者的预后明显比其他患者严重：15例自身抗体阳性的患者中有6例(40%)在住院期间死于新冠肺炎并发症，而18例未检测自身抗体的患者中只有1例(5.5%)死亡(P=0.03)。预后不良(死于新冠肺炎并发症)的患者入院时呼吸频率(23次/分钟比17次/分钟；P=0.03)和自身抗体频率(86%比27%；P=0.008)显著增加。总之，在新冠肺炎患者中经常检测到自身抗体，这可能反映了免疫失调在发病中的作用。然而，考虑到患者数量很少，自身抗体与不良预后的关联需要进一步的多中心研究。
Coronavirus disease 2019 (COVID‐19) is often associated with interstitial pneumonia. However, there is insufficient knowledge on the presence of autoimmune serological markers in patients with COVID‐19. We analyzed the presence and role of autoantibodies in patients with COVID‐19‐associated pneumonia. We prospectively studied 33 consecutive patients with COVID‐19, 31 (94%) of whom had interstitial pneumonia, and 25 age‐matched and sex‐matched patients with fever and/or pneumonia with etiologies other than COVID‐19 as the pathological control group. All patients were tested for the presence of antinuclear antibodies (ANAs), anti‐antiphospholipid antibodies, and anti‐cytoplasmic neutrophil antibodies (ANCAs). Clinical, biochemical, and radiological parameters were also collected. Fifteen of 33 patients (45%) tested positive for at least one autoantibody, including 11 who tested positive for ANAs (33%), 8 who tested positive for anti‐cardiolipin antibodies (immunoglobulin (Ig)G and/or IgM; 24%), and 3 who tested positive for anti‐β2‐glycoprotein antibodies (IgG and/or IgM; 9%). ANCA reactivity was not detected in any patient. Patients that tested positive for auto‐antibodies had a significantly more severe prognosis than other patients did: 6 of 15 patients (40%) with auto‐antibodies died due to COVID‐19 complications during hospitalization, whereas only 1 of 18 patients (5.5%) who did not have auto‐antibodies died (P = 0.03). Patients with poor prognosis (death due to COVID‐19 complications) had a significantly higher respiratory rate at admission (23 breaths per minute vs. 17 breaths per minute; P = 0.03) and a higher frequency of auto‐antibodies (86% vs. 27%; P = 0.008). In conclusion, auto‐antibodies are frequently detected in patients with COVID‐19 possibly reflecting a pathogenetic role of immune dysregulation. However, given the small number of patients, the association of auto‐antibodies with an unfavorable prognosis requires further multicenter studies.
登录
查看更多内容
影响因子：
3.8
作者：
Ki, Moran
通讯作者：
Ki, Moran
影响因子：
2.8
作者：
(Wojciechowska), Joanna Krajewska;Koscielska-Kasprzak, Katarzyna;Morawski, Krzysztof
通讯作者：
Morawski, Krzysztof
影响因子：
5
作者：
Avcin, Tadej;Toplak, Natasa
通讯作者：
Toplak, Natasa
影响因子：
19
作者：
Mizumoto, Kenji;Kagaya, Katsushi;Chowell, Gerardo
通讯作者：
Chowell, Gerardo
影响因子：
33.9
作者：
Kimball, Anne;Hatfield, Kelly M.;Jernigan, John A.
通讯作者：
Jernigan, John A.