Prevalence of type-1 interferon autoantibodies in adults with non-COVID-19 acute respiratory failure

Abstract

Auto-antibodies (Abs) to type I interferons (IFNs) are found in up to 25% of patients with severe COVID-19, and are implicated in disease pathogenesis. It has remained unknown, however, whether type I IFN auto-Abs are unique to COVID-19, or are also found in other types of severe respiratory illnesses. To address this, we studied a prospective cohort of 284 adults with acute respiratory failure due to causes other than COVID-19. We measured type I IFN auto-Abs by radio ligand binding assay and screened for respiratory viruses using clinical PCR and metagenomic sequencing. Three patients (1.1%) tested positive for type I IFN auto-Abs, and each had a different underlying clinical presentation. Of the 35 patients found to have viral infections, only one patient tested positive for type I IFN auto-Abs. Together, our data suggest that type I IFN auto-Abs are uncommon in critically ill patients with acute respiratory failure due to causes other than COVID-19.

Keywords: Acute respiratory failure; Anti-interferon antibodies; Auto-antibodies; COVID-19; Type I interferon.

Fig. 1

A Type I IFN auto-Ab detection by radioligand binding assay (RLBA) in adults with acute respiratory failure due to causes other than COVID-19 (blue), healthy control patients (black), or positive control patients with autoimmune polyglandular syndrome-1 (APS-1, red). Clinical features of the three patients with anti-type I IFN antibodies are described right of the panel. B Viruses detected in patients with pneumonia based a combination of multiplex respiratory viral PCR and metagenomic next generation RNA sequencing