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. 2024 Nov 20;45(1):45.
doi: 10.1007/s10875-024-01839-x.

Similar Kinetics of Pulmonary SARS-CoV-2 Load in Intensive Care Unit Patients with COVID-19 Pneumonia with or Without Autoantibodies Neutralizing Type I Interferons

Valentine Le Stang  1 , Paul Bastard  2   3   4   5 , Elise Langouet  1 , Marc Pineton de Chambrun  1 , Juliette Chommeloux  1 , Adrian Gervais  3   4 , Lucy Bizien  3   4 , Anne Puel  2   3   4 , Aurélie Cobat  2   3   4 , Julien Mayaux  6 , Alexandre Demoule  6 , Jean-Laurent Casanova  2   3   4   7   8 , David Boutolleau  9 , Alain Combes  1   10 , Sonia Burrel  11 , Charles-Edouard Luyt  12   13   14
Affiliations

Similar Kinetics of Pulmonary SARS-CoV-2 Load in Intensive Care Unit Patients with COVID-19 Pneumonia with or Without Autoantibodies Neutralizing Type I Interferons

Valentine Le Stang et al. J Clin Immunol. .

Abstract

Purpose: The pathogenesis of life-threatening coronavirus disease 2019 (COVID-19) pneumonia in ICU patients can involve pre-existing auto-antibodies (auto-Abs) neutralizing type I interferons (IFNs). The impact of these auto-Abs on SARS-CoV-2 clearance in the lower respiratory tract (LRT) is unclear.

Methods: We performed a retrospective study in 99 ICU patients with COVID-19 pneumonia between March and May 2020. LRT SARS-CoV-2 load (intensity and duration) was analyzed according to the presence or not of circulating auto-Abs neutralizing type I IFNs.

Results: Among the 99 included patients, 38 (38%) were positive for auto-Abs neutralizing type I IFNs, with 5 (5%) harboring auto-Abs neutralizing IFN-α2 at any concentration, while 33 (33%) had auto-Abs neutralizing only IFN-ω at the lower concentration. SARS-CoV-2 load in the LRT and duration of viral shedding, were similar in patients with or without auto-Abs neutralizing type I IFNs. Patients with auto-Abs had the same mortality than those without auto-Abs, despite greater occurrence of renal failure and ECMO support, and longer duration of mechanical ventilation and ICU stay.

Conclusion: In summary, 5% of patients with critical COVID-19 pneumonia carried auto-Abs neutralizing IFN-α2, while about 1/3 harbored auto-Abs neutralizing low concentrations of IFN-ω. The detection of either type of auto-Abs did not impact LRT viral clearance and mortality, although it was associated with greater morbidity and a longer hospitalization. These findings suggest that similar albeit hitherto unknown mechanisms of disease drive critical COVID-19 pneumonia in patients without auto-Abs against type I IFNs.

Keywords: Auto-antibodies; Interferon; SARS-CoV-2; Viral clearance.

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Conflict of interest statement

Declarations. Ethics Approval and Consent to Participate: In accordance with current French law, informed written consent for demographic, physiologic and hospital-outcome data analyses was not obtained because this observational study did not modify existing diagnostic or therapeutic strategies. Nonetheless, patients and/or relatives were informed about the anonymous data collection and told that they could decline inclusion. The protocol was approved by the ethics committee of the Société de Réanimation de Langue Française (registration no. CE-SRLF-2093) and the database is registered with the Commission Nationale de l’Informatique et des Libertés (CNIL, registration no. 1950673). Competing Interests: The authors declare no competing interests.

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References

    1. Eto S, Nukui Y, Tsumura M, Kashimada K, Mizoguchi Y, Utsumi T, et al. Neutralizing Type I Interferon Autoantibodies in Japanese Patients with Severe COVID-19. J Clin Immunol. 2022;42:1360–70. - PMC - PubMed
    1. Solanich X, Rigo-Bonnin R, Gumucio V-D, Bastard P, Rosain J, Philippot Q, et al. Pre-existing Autoantibodies Neutralizing High Concentrations of Type I Interferons in Almost 10% of COVID-19 Patients Admitted to Intensive Care in Barcelona. J Clin Immunol. 2021;1733–44. - PMC - PubMed
    1. Bastard P, Rosen LB, Zhang Q, Michailidis E, Hoffmann H-H, Zhang Y, et al. Autoantibodies against type I IFNs in patients with life-threatening COVID-19. Science. 2020;370:eabd4585. - PMC - PubMed
    1. Chauvineau-Grenier A, Bastard P, Servajean A, Gervais A, Rosain J, Jouanguy E, et al. Autoantibodies Neutralizing Type I Interferons in 20% of COVID-19 Deaths in a French Hospital. J Clin Immunol. 2022;42:459–70. - PMC - PubMed
    1. Arrestier R, Bastard P, Belmondo T, Voiriot G, Urbina T, Luyt C-E, et al. Auto-antibodies against type I IFNs in > 10% of critically ill COVID-19 patients: a prospective multicentre study. Ann Intensive Care. 2022;12:121. - PMC - PubMed

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