COVID: persistent autoimmunity in patients, with or without symptoms

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Several studies have shown that severe cases of COVID-19 stress the immune system so much that it begins to produce autoantibodies. But recent research from Cedars-Sinai Medical Center (Los Angeles, California) found that after SARS-CoV-2 infection, immune responses persist beyond the introduction of the virus into the body and the patient’s full recovery. The study also shows that these autoimmune reactions occur even in mild or asymptomatic cases of the disease.

The new disease that will have caused the most impact in the last decade, COVID-19, still hides a series of unsolved enigmas, which researchers around the world are trying to solve. The immune responses of humans to disease are the subject of much research.

In this area, Cedars-Sinai scientists have discovered for the first time not only elevated levels of autoantibodies after a mild or asymptomatic infection, but also their persistence over time. Details of the study have been published in the Journal of Translational Medicine.

Autoantibodies are, in fact, the most common immune responses seen in pathologies such as lupus or rheumatoid arthritis. It is an immune system disorder in which antibodies that are supposed to protect the body attack healthy cells.

To study the phenomenon in the case of COVID-19, the Cedars-Sinai researchers asked 177 people with confirmed evidence of prior infection with SARS-CoV-2. They then conducted comparative analyzes of samples taken from the latter and with samples from healthy people before the pandemic. The results revealed that all of the infected people had high levels of autoantibodies. Some of these autoantibodies were the same as those found in lupus and rheumatoid arthritis.

A paradox in discovery

“We found signs of autoimmune activity generally related to chronic inflammation and damage involving specific organ systems and tissues, such as the joints, skin, and nervous system,” Susan Cheng, of the Department of Cardiology at Smidt Heart, said in a statement. Institute and co. -Main author of the study.

This discovery also revealed that some of these autoantibodies were linked to autoimmune diseases that more commonly affect women than men. Still, the results showed that men had higher autoantibody levels than women.

“On the one hand, this finding is paradoxical, given that autoimmune diseases are generally more common in women,” says Justyna Fert-Bober, a researcher in the department of cardiology at the Smidt Heart Institute and co-senior author of the study. study. “On the other hand, it is also somewhat expected given everything we know about men being more vulnerable to more severe forms of COVID-19,” he adds.

Autoantibodies potentially at the origin of “prolonged COVID”

According to the Cedars-Sinai researchers, these immune disorders could be the cause of persistent symptoms seen in people with the so-called “long” form. People with this form of the disease show symptoms up to 4 weeks after infection. However, in most cases, they go away after 2 to 3 weeks.

However, this study was done before the advent of vaccines and immune responses might be different in vaccinated people. Therefore, future research will focus on autoantibodies that can be generated by newly infected individuals. It will also investigate the types of autoantibodies that may be present and persist in people with long-term symptoms of COVID-19. This could open the way to more effective vaccines or new treatments.

“If we can better understand these autoantibody responses and how SARS-CoV-2 infection triggers and drives these variable responses, then we can go a step further to identify ways to treat and even prevent these effects from developing in people in risk”. Chen said.

Journal of Translational Medicine (2021)

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