Division of Infectious Diseases, Department of Internal Medicine and AIDS Research Institute, Yonsei University College of Medicine, Seoul, Republic of Korea.
Division of Infectious Diseases, Department of Internal Medicine, Inha University College of Medicine, Incheon, Republic of Korea.
Virol J. 2023 Oct 16;20(1):236. doi: 10.1186/s12985-023-02191-z.
Interest in complications and sequelae following Coronavirus disease 2019 (COVID-19) is increasing. Several articles have reported COVID-19-associated autoimmune diseases and the association between autoantibodies and the severity of COVID-19. Thromboembolic complications are frequent in patients with COVID-19, and the anti-phospholipid antibodies (aPL) is frequently detected. We conducted this study to investigate the prevalence, clinical significance, and persistence of anti-nuclear antibodies (ANA) and aPLs in COVID-19.
We enrolled patients diagnosed with COVID-19 with oxygen demand and admitted to a tertiary hospital in South Korea between July 2020 and March 2022. ANA and aPLs levels were assessed using an immunoassay kit.
A total of 248 patients were enrolled in the study. Among them, five patients were ANA-positive, and 41 were aPL-positive (IgM anti-cardiolipin (aCL) antibody in seven patients, IgG aCL in seven patients, IgM anti-β2Glycoprotein1 antibody (aβ2-GPI) in 32 patients, and IgG aβ2-GPI in one patient). Two of five ANA-positive patients, 13 of 32 IgM aβ2-GPI-positive patients, 5 of 7 IgM aCL-positive patients, and 2 of 7 IgG aCL-positive patients were eligible for follow-up analysis, and 100%, 69.2%, 40%, and 50% of the patients remained autoantibody-positive, respectively. There were no differences in clinical outcomes between the autoantibody-positive and autoantibody-negative groups, except for the IgG aCL group showing a tendency for worse outcomes.
A significant proportion of COVID-19 patients with oxygen demand were autoantibody-positive, and autoantibodies persisted for several months after symptom onset. Whether these autoantibodies are related to long-term sequelae in COVID-19 patients requires further investigation.
人们对 2019 年冠状病毒病（COVID-19）后并发症和后遗症的兴趣日益增加。有几篇文章报道了 COVID-19 相关的自身免疫性疾病以及自身抗体与 COVID-19 严重程度之间的关系。COVID-19 患者常发生血栓栓塞并发症，且常检测到抗磷脂抗体（aPL）。我们进行这项研究旨在调查 COVID-19 患者抗核抗体（ANA）和 aPL 的流行率、临床意义和持续性。
我们纳入了 2020 年 7 月至 2022 年 3 月期间在韩国一家三级医院因需要吸氧而被诊断为 COVID-19 的患者。使用免疫分析法试剂盒评估 ANA 和 aPL 水平。
共有 248 例患者入组本研究。其中，5 例患者 ANA 阳性，41 例 aPL 阳性（7 例患者 IgM 抗心磷脂（aCL）抗体、7 例患者 IgG aCL、32 例患者 IgM 抗β2-糖蛋白 1 抗体（aβ2-GPI）、1 例患者 IgG aβ2-GPI）。5 例 ANA 阳性患者中的 2 例、32 例 IgM aβ2-GPI 阳性患者中的 13 例、7 例 IgM aCL 阳性患者中的 5 例和 7 例 IgG aCL 阳性患者中的 2 例符合随访分析条件，分别有 100%、69.2%、40%和 50%的患者持续存在自身抗体阳性。自身抗体阳性组和自身抗体阴性组之间除 IgG aCL 组的结局有恶化趋势外，其他临床结局均无差异。
有相当比例的需要吸氧的 COVID-19 患者存在自身抗体阳性，且症状出现后几个月内持续存在自身抗体。这些自身抗体是否与 COVID-19 患者的长期后遗症有关，需要进一步研究。
