SARS‐CoV‐2 infection and increasing autoimmune disorders among ICU‐hospitalized COVID‐19 patients

Abstract

AbstractIntroductionIn acute conditions, severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) causes multi‐organ damage due to the induction of inappropriate immune responses, particularly lung tissue fibrosis. To evaluate the consequence of the deterioration of the immune system, autoimmune markers were assessed.MethodsIn a case–control study, 108 patients with coronavirus disease 2019 (COVID‐19) were admitted to the intensive care unit (ICU), and 158 outpatients with mild clinical symptoms, with SARS‐CoV‐2 reverse transcription quantitative polymerase chain reaction (RT‐qPCR) positive tests, were included for comparison. The demographic and hematologic variables and presence of the main autoantibodies in sera of 40 eligible ICU‐hospitalized COVID‐19 patients and 40 COVID‐19 outpatients were assessed. Out of 108 COVID‐19 ICU‐hospitalized patients, 40 were selected as the control group (40/158) who had no underlying diseases before hospitalization, according to their self‐declaration and clinical records at the time of admission.ResultsThe results demonstrated that the main complete blood count indices, such as red blood cells and platelets, decreased dramatically in ICU‐hospitalized patients. Furthermore, the autoantibody profiles were positive in 45% and 15% of ICU‐admitted patients for antinuclear antibodies and antineutrophilic cytoplasmic autoantibodies, respectively. In ICU patients, anti‐PM/Scl 100 or AMA‐M2 was 33%. Anti SS‐A, anti‐SS‐B, anti‐Ro‐52, and anti‐Jo‐1 in 11.5% for each one were reactive. Other autoantibodies of the ICU group were as follows: CENP (5.6%), Rib‐protein (5.6%), and nucleosome (5.6%). However, only two individuals in the control group had positive results for SS‐A and SS‐B (5%).ConclusionInduction of such particular autoantibodies by the virus can justify the multi‐organ involvement and severity of the disease in ICU patients, which may also cause other organ involvement in the long term.