Distinct Subsets of Anti-Pulmonary Autoantibodies Correlate with Disease Severity and Survival in Severe COVID-19 Patients

Tóth, Emese and Fagyas, Miklós and Nagy, Béla and Mányiné Siket, Ivetta and Szőke, Blanka and Mártha, Lilla and Mahdi, Mohamed and Erdősi, Gábor and Pólik, Zsófia and Kappelmayer, János and Papp, Zoltán and Borbély, Attila and Szabó, Tamás and Balla, József and Balla, György and Bácsi, Attila and Szekanecz, Zoltán and Bai, Peter and Tóth, Attila (2023) Distinct Subsets of Anti-Pulmonary Autoantibodies Correlate with Disease Severity and Survival in Severe COVID-19 Patients. GEROSCIENCE : OFFICIAL JOURNAL OF THE AMERICAN AGING ASSOCIATION (AGE). pp. 1-14. ISSN 2509-2723

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Abstract

Autoantibodies targeting the lung tissue were identified in severe COVID-19 patients in this retrospective study. Fifty-three percent of 104 patients developed anti-pulmonary antibodies, the majority of which were IgM class, suggesting that they developed upon infection with SARS-CoV-2. Anti-pulmonary antibodies correlated with worse pulmonary function and a higher risk of multiorgan failure that was further aggravated if 3 or more autoantibody clones were simultaneously present (multi-producers). Multi-producer patients were older than the patients with less or no autoantibodies. One of the identified autoantibodies (targeting a pulmonary protein of ~ 50 kDa) associated with worse clinical outcomes, including mortality. In summary, severe COVID-19 is associated with the development of lung-specific autoantibodies, which may worsen the clinical outcome. Tissue proteome-wide tests, such as the ones applied here, can be used to detect autoimmunity in the post-COVID state to identify the cause of symptoms and to reveal a new target for treatment.

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