Department of Respiratory and Critical Care Medicine, West China Hospital, Sichuan University, Chengdu, China.
National Health Commission of the People's Republic of China (NHC), Key Laboratory of Systems Biology of Pathogens and Christophe Merieux Laboratory, Institute of Pathogen Biology, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
Front Immunol. 2021 Dec 20;12:791348. doi: 10.3389/fimmu.2021.791348. eCollection 2021.
Striking similarities have been found between coronavirus disease 2019 (COVID-19) and anti-melanoma differentiation-associated gene 5 (MDA5) antibody (Ab)-related dermatomyositis, implying a shared autoinflammatory aberrance. Herein, we aim to investigate whether the anti-MDA5 Ab is present in COVID-19 and correlates with the severity and adverse outcome of COVID-19 patients.
We retrospectively recruited 274 adult inpatients with COVID-19 in this study, including 48, 164, and 62 cases of deaths, severe, and non-severe patients respectively. The anti-MDA5 Ab was determined by ELISA and verified by Western Blotting, which indicated that the positive rate of anti-MDA5 Ab in COVID-19 patients was 48.2% (132/274). The clinical and laboratory features, as well as outcomes between patients with positive and negative anti-MDA5 Ab were compared and we found that the anti-MDA5 Ab positive patients tended to represent severe disease (88.6% 66.9%, <0.0001). We also demonstrated that the titer of anti-MDA5 Ab was significantly elevated in the non-survivals (5.95 ± 5.16 8.22 ± 6.64, =0.030) and the positive rate was also higher than that in the survivals (23.5% 12.0%, =0.012). Regarding severe COVID-19 patients, we found that high titer of anti-MDA5 Ab (≥10.0 U/mL) was more prevalent in the non-survivals (31.2% 14.0%, =0.006). Moreover, a dynamic analysis of anti-MDA5 Ab was conducted at different time-points of COVID-19, which revealed that early profiling of anti-MDA5 Ab could distinguish severe patients from those with non-severe ones.
Anti-MDA5 Ab was prevalent in the COVID-19 patients and high titer of this antibody is correlated with severe disease and unfavorable outcomes.
新冠肺炎（COVID-19）和抗黑色素瘤分化相关基因 5（MDA5）抗体（Ab）相关皮肌炎之间存在显著相似性，这意味着存在共同的自身炎症异常。在此，我们旨在研究 COVID-19 患者中是否存在抗 MDA5 Ab，并探讨其与 COVID-19 患者严重程度和不良预后的相关性。
本研究回顾性纳入了 274 例成年 COVID-19 住院患者，其中死亡、重症和非重症患者分别为 48、164 和 62 例。采用 ELISA 法检测抗 MDA5 Ab，Western Blotting 法进行验证，结果表明 COVID-19 患者抗 MDA5 Ab 的阳性率为 48.2%（132/274）。比较了抗 MDA5 Ab 阳性和阴性患者的临床和实验室特征以及结局，发现抗 MDA5 Ab 阳性患者更倾向于表现为重症疾病（88.6%比 66.9%，<0.0001）。我们还发现，非存活者的抗 MDA5 Ab 滴度明显升高（5.95±5.16比 8.22±6.64，=0.030），阳性率也高于存活者（23.5%比 12.0%，=0.012）。对于重症 COVID-19 患者，我们发现高滴度的抗 MDA5 Ab（≥10.0 U/mL）在非存活者中更为常见（31.2%比 14.0%，=0.006）。此外，我们还对 COVID-19 不同时间点的抗 MDA5 Ab 进行了动态分析，结果表明早期抗 MDA5 Ab 谱可将重症患者与非重症患者区分开来。
抗 MDA5 Ab 在 COVID-19 患者中较为常见，该抗体的高滴度与重症疾病和不良结局相关。
