Severe Coronavirus Disease 2019 (COVID-19) is Associated With Elevated Serum Immunoglobulin (Ig) A and Antiphospholipid IgA Antibodies (vol 73, e2869, 2021)

被引：2

作者：

Ali, Omar Hasan ^{[1
,2
,3
]}

Bomze, David ^{[3
,4
]}

Risch, Lorenz ^{[5
,6
]}

Brugger, Silvio D. ^{[7
]}

Paprotny, Matthias ^{[8
]}

Weber, Myriam ^{[8
]}

Thiel, Sarah ^{[8
]}

Kern, Lukas ^{[9
]}

Albrich, Werner C. ^{[10
]}

Kohler, Philipp ^{[10
]}

Kahlert, Christian R. ^{[10
,11
]}

Vernazza, Pietro ^{[10
]}

Buhler, Philipp K. ^{[12
]}

Schupbach, Reto A. ^{[12
]}

Gomez-Mejia, Alejandro ^{[7
]}

Popa, Alexandra M. ^{[13
]}

Bergthaler, Andreas ^{[13
]}

Penninger, Josef M. ^{[1
,14
]}

Flatz, Lukas ^{[2
,3
,15
,16
]}

机构：

[1] Univ British Columbia, Inst Life Sci, Dept Med Genet, Vancouver, BC, Canada

[2] Univ Hosp Zurich, Dept Dermatol, Zurich, Switzerland

[3] Kantonsspital St Gallen, Inst Immunobiol, Rorschacher Str 95, CH-9007 St Gallen, Switzerland

[4] Tel Aviv Univ, Sackler Fac Med, Tel Aviv, Israel

[5] Lab Med Zentrum Dr Risch, Vaduz, Liechtenstein

[6] Univ Bern, Univ Inst Clin Chem, Ctr Lab Med, Bern, Switzerland

[7] Univ Hosp Zurich, Dept Infect Dis & Hosp Hyg, Zurich, Switzerland

[8] Landesspital Liechtenstein, Dept Gen Internal Med, Vaduz, Liechtenstein

[9] Kantonsspital St Gallen, Dept Pulmonol, St Gallen, Switzerland

[10] Kantonsspital St Gallen, Div Infect Dis & Hosp Epidemiol, St Gallen, Switzerland

[11] Childrens Hosp Eastern Switzerland, Dept Infect Dis & Hosp Epidemiol, St Gallen, Switzerland

[12] Univ Hosp Zurich, Inst Intens Care Med, Zurich, Switzerland

[13] Austrian Acad Sci, Res Ctr Mol Med, Vienna, Austria

[14] Austrian Acad Sci, Inst Mol Biotechnol, Vienna, Austria

[15] Kantonsspital St Gallen, Dept Dermatol, St Gallen, Switzerland

[16] Kantonsspital St Gallen, Dept Oncol & Hematol, St Gallen, Switzerland

来源：

CLINICAL INFECTIOUS DISEASES | 2021年 / 73卷 / 09期

基金：

瑞士国家科学基金会;

关键词：

antiphospholipid syndrome; autoimmunity; COVID-19; immunoglobulin A; thromboembolisms;

D O I：

10.1093/cid/ciab532

中图分类号：

R392 [医学免疫学]; Q939.91 [免疫学];

学科分类号：

100102 ;

摘要：

Background: Severe coronavirus disease 2019 (COVID-19) frequently entails complications that bear similarities to autoimmune diseases. To date, there are little data on possible immunoglobulin (Ig) A-mediated autoimmune responses. Here, we aim to determine whether COVID-19 is associated with a vigorous total IgA response and whether IgA antibodies are associated with complications of severe illness. Since thrombotic events are frequent in severe COVID-19 and resemble hypercoagulation of antiphospholipid syndrome, our approach focused on antiphospholipid antibodies (aPL). Methods: In this retrospective cohort study, clinical data and aPL from 64 patients with COVID-19 were compared from 3 independent tertiary hospitals (1 in Liechtenstein, 2 in Switzerland). Samples were collected from 9 April to 1 May 2020. Results: Clinical records of 64 patients with COVID-19 were reviewed and divided into a cohort with mild illness (mCOVID; 41%), a discovery cohort with severe illness (sdCOVID; 22%) and a confirmation cohort with severe illness (scCOVID; 38%). Total IgA, IgG, and aPL were measured with clinical diagnostic kits. Severe illness was significantly associated with increased total IgA (sdCOVID, P =. 01; scCOVID, P <. 001), but not total IgG. Among aPL, both cohorts with severe illness significantly correlated with elevated anticardiolipin IgA (sdCOVID and scCOVID, P <. 001), anticardiolipin IgM (sdCOVID, P =. 003; scCOVID, P<. 001), and anti-beta 2 glycoprotein-1 IgA (sdCOVID and scCOVID, P<. 001). Systemic lupus erythematosus was excluded from all patients as a potential confounder. Conclusions: Higher total IgA and IgA-APL were consistently associated with severe illness. These novel data strongly suggest that a vigorous antiviral IgA response, possibly triggered in the bronchial mucosa, induces systemic autoimmunity. © 2020 The Author(s) 2020. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail: journals.permissions@oup.com.

引用

页码：1746 / 1746

页数：1