Immunologic markers, vasculitis-associated autoantibodies, and complement levels in patients with COVID-19

Abstract

Background: The cause of coronavirus disease 2019 (COVID-19) is a virus which can lead to severe acute respiratory syndrome-CoV-2 (SARS-COV-2). There are evidences of involvement of immune system in pathogenesis of this disease. We investigated the presence of various vasculitis-associated autoantibodies and complement levels in patients with COVID-19. Materials and Methods: Patients with severe or critical type of COVID-19 were evaluated for symptoms, signs, and laboratory tests of vasculitis syndromes including rheumatoid factor (RF), antinuclear antibody (ANA), anti-double-stranded DNA, c and p anti-neutrophilic cytoplasmic antibody (c ANCA and P ANCA), and complement levels. Results: The study was performed in forty patients with severe or critical illness. The mean age of the participants was 48.5 ± 9.8 years. All patients had pulmonary involvement in lung computed tomography scans. Vasculitis laboratory test results included RF in two patients, ANA in three patients, and ANCA in one patient. Seventeen (42.5%) patients had hypocomplementemia in one or more complement tests. Four patients expired, of whom three had a decrease in complement level. Conclusion: Decrease in complement levels may predict a critical state of COVID-19 disease. Therefore, measuring its levels may be of great benefit in making earlier decisions to initiate disease-suppressing treatments including corticosteroids.

Autoantibodies in COVID‐19, a possible role in the pathogenesis of the disease

“…Inflammatory molecules were higher in ANCA‐positive patients, as well as the mortality, but without statistical significance [7]. The study of Mobini et al found positive ANA in three patients, and ANCA in one among 40 tested patients [18]. Our cohort was significantly older, what may be the main reason for different results, while age itself significantly contributed to development of antibodies in our group.…”

“…A series of recent publications have reported the development of vasculitis‐like illness and auto‐immune phenomena in patients recovering from COVID‐19 [15, 16]. However, data on the frequency and role of ANCA and ANAs in patients with COVID‐19 are scarce and focused on patients with the severe form of the disease [4, 6, 7, 17, 18]. To our knowledge, this is the first study focused on the antibody development in hospitalized patients with different severity of acute COVID‐19.…”

Autoimmune and Autoinflammatory Connective Tissue Disorders Following COVID-19

“…Widely distributed tissue antigens may be a target of cross-reactive antibodies generated against SARS-CoV-2 epitopes. 23 Individuals with COVID-19 were reported to have low levels of complements 24 and positive autoantibodies. 25 , 26 , 27 , 28 , 29 Another hypothesis suggested that the release of cytokines (ie, a cytokine storm) may trigger autoimmune responses as bystander activation.…”

Importancia clínica de los anticuerpos antinucleares en la COVID-19: una revisión sistemática con síntesis narrativa

“…La mayoría de los estudios (n = 18) incluidos en esta revisión sistemática utilizaron la inmunofluorescencia indirecta como método principal de detección de ANA, pero los puntos de corte utilizados para determinar la positividad variaron entre los estudios, debido a que algunos los establecieron en valores de dilución por encima de 1:80 o 1:160, o valores más bajos, de apenas 1:40 18 . Por otra parte, tres estudios utilizaron la prueba de ELISA para la detección de ANA, informando tasas de prevalencia relativamente bajas, entre el 6% y el 8% [17][18][19] . Dos estudios utilizaron analizadores automatizados 20,21 .…”