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. 2021:4:100091.
doi: 10.1016/j.jtauto.2021.100091. Epub 2021 Mar 2.

Latent rheumatic, thyroid and phospholipid autoimmunity in hospitalized patients with COVID-19

Juan-Manuel Anaya  1 , Diana M Monsalve  1 , Manuel Rojas  1 , Yhojan Rodríguez  1   2 , Norma Montoya-García  2 , Laura Milena Mancera-Navarro  2 , Ana María Villadiego-Santana  2 , Giovanni Rodríguez-Leguizamón  3   4 , Yeny Acosta-Ampudia  1 , Carolina Ramírez-Santana  1
Affiliations

Latent rheumatic, thyroid and phospholipid autoimmunity in hospitalized patients with COVID-19

Juan-Manuel Anaya et al. J Transl Autoimmun. 2021.

Abstract

Autoimmune responses mediated by autoantibodies have been observed in SARS-CoV-2 infection. Herein, we evaluate the presence of rheumatic, thyroid and phospholipid autoantibodies in sera samples from 120 adult hospitalized patients with COVID-19 in comparison to pre-pandemic samples from 100 healthy individuals. In addition, to estimate the frequency of these autoantibodies in COVID-19, a meta-analysis of selected articles was conducted. Hospitalized patients with COVID-19 had latent autoimmunity characterized by a high frequency of anti-thyroid peroxidase antibodies, rheumatoid factor (RF), anti-cyclic citrullinated peptide third generation antibodies, antinuclear antibodies (ANAs), IgM anti-β2-glycoprotein I (β2GP1) and IgM anti-cardiolipin antibodies. The meta-analysis confirmed our results, with RF and ANAs being the most common autoantibodies. In addition, cluster analysis revealed that those patients with high frequency of RF, IgM anti-β2GP1 antibodies and ANAs had a longer hospital stay, required more vasopressors during hospitalization, and were more likely to develop critical disease. These data suggest that latent autoimmunity influences the severity of COVID-19, and support further post-COVID studies in order to evaluate the development of overt autoimmunity.

Keywords: Autoimmunity; COVID-19; Clusters; Latent autoimmunity; SARS-CoV-2.

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Conflict of interest statement

The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

Figures

Fig. 1
Fig. 1
Marginal probabilities for critical disease based on IgG ACA levels. MV: Mechanical ventilation; ACA: Anti-cardiolipin antibody.
Fig. 2
Fig. 2
Radar plots of frequency of autoantibodies by cluster. ACA: Anti-cardiolipin antibodies; ANAs: Anti nuclear antibodies; β2GP1: β2-Glycoprotein 1; CCP3: anti-cyclic citrullinated peptide third generation; RF: Rheumatoid factor; TPO: Thyroid peroxidase antibodies.
Fig. 3
Fig. 3
Continuum spectrum of autoimmunity. From latent to overt autoimmune diseases. AD: autoimmune disease.
See this image and copyright information in PMC

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