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Auto-antibodies against type I IFNs in > 10% of critically ill COVID-19 patients: a prospective multicentre study

BACKGROUND: Auto-antibodies (auto-Abs) neutralizing type I interferons (IFN) have been found in about 15% of critical cases COVID-19 pneumonia and less than 1% of mild or asymptomatic cases. Determining whether auto-Abs influence presentation and outcome of critically ill COVID-19 patients could lea...

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Detalles Bibliográficos
Autores principales: Arrestier, Romain, Bastard, Paul, Belmondo, Thibaut, Voiriot, Guillaume, Urbina, Tomas, Luyt, Charles-Edouard, Gervais, Adrian, Bizien, Lucy, Segaux, Lauriane, Ben Ahmed, Mariem, Bellaïche, Raphaël, Pham, Taï, Ait-Hamou, Zakaria, Roux, Damien, Clere-Jehl, Raphael, Azoulay, Elie, Gaudry, Stéphane, Mayaux, Julien, Fage, Nicolas, Ait-Oufella, Hafid, Moncomble, Elsa, Parfait, Mélodie, Dorgham, Karim, Gorochov, Guy, Mekontso-Dessap, Armand, Canoui-Poitrine, Florence, Casanova, Jean-Laurent, Hue, Sophie, de Prost, Nicolas
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer International Publishing 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9803887/
https://www.ncbi.nlm.nih.gov/pubmed/36586050
http://dx.doi.org/10.1186/s13613-022-01095-5
Descripción
Sumario:BACKGROUND: Auto-antibodies (auto-Abs) neutralizing type I interferons (IFN) have been found in about 15% of critical cases COVID-19 pneumonia and less than 1% of mild or asymptomatic cases. Determining whether auto-Abs influence presentation and outcome of critically ill COVID-19 patients could lead to specific therapeutic interventions. Our objectives were to compare the severity at admission and the mortality of patients hospitalized for critical COVID-19 in ICU with versus without auto-Abs. RESULTS: We conducted a prospective multicentre cohort study including patients admitted in 11 intensive care units (ICUs) from Great Paris area hospitals with proven SARS-CoV-2 infection and acute respiratory failure. 925 critically ill COVID-19 patients were included. Auto-Abs neutralizing type I IFN-α2, β and/or ω were found in 96 patients (10.3%). Demographics and comorbidities did not differ between patients with versus without auto-Abs. At ICU admission, Auto-Abs positive patients required a higher FiO(2) (100% (70–100) vs. 90% (60–100), p = 0.01), but were not different in other characteristics. Mortality at day 28 was not different between patients with and without auto-Abs (18.7 vs. 23.7%, p = 0.279). In multivariable analysis, 28-day mortality was associated with age (adjusted odds ratio (aOR) = 1.06 [1.04–1.08], p < 0.001), SOFA score (aOR = 1.18 [1.12–1.23], p < 0.001) and immunosuppression (aOR = 1.82 [1.1–3.0], p = 0.02), but not with the presence of auto-Abs (aOR = 0.69 [0.38–1.26], p = 0.23). CONCLUSIONS: In ICU patients, auto-Abs against type I IFNs were found in at least 10% of patients with critical COVID-19 pneumonia. They were not associated with day 28 mortality. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s13613-022-01095-5.