The development of anti-cyclic citrullinated peptide (Anti-CCP) antibody following severe COVID-19

Abstract

The dysregulated immune response is one of the cardinal features of severe coronavirus disease-2019 (COVID-19). This study has been conducted to clarify the occurrence of AABs associated with a systemic autoimmune rheumatic disease (SARD) in hospitalized patients with a moderate, severe, and critical form of COVID-19. The serum samples obtained from one hundred seventy-six hospitalized COVID-19 patients were enrolled in this study, including patients with moderate (N = 90), severe (N = 50), and critical (N = 36) forms of COVID-19. Serum samples collected from healthy subjects before the COVID-19 pandemic were used as control. The ANA, ds-DNA, c-ANCA, p-ANCA, aPL, and anti-CCP occurrence was evaluated using a solid-phase enzyme-linked immunosorbent assay (ELISA). The occurrence of ANA, anti-dsDNA, Anti-CCP, c-ANCA, and p-ANCA was significantly higher in the COVID-19 patients compared to serum obtained from healthy subjects (P = 0.0001, P = 0.0001, P = 0.0001, P = 0.030, and P = 0.001 respectively). The positive number of anti-CCP tests increased significantly in severe COVID-19 compared to the moderate group (P = 0.002). Our study further supports the development of autoantibodies related to systemic autoimmune rheumatologic diseases (SARD). To the best of our knowledge, this is the first study with a large sample size that reported the occurrence of anti-CCP in a severe form of COVID-19.