Autoantibodies neutralizing type I interferons remain a significant risk factor for critical COVID-19 pneumonia in vaccinated patients

IF 4.5 3区医学 Q2 IMMUNOLOGY

Clinical immunology Pub Date : 2025-04-02 DOI:10.1016/j.clim.2025.110491

Arnau Antolí , José Luis Gómez-Vázquez , Angels Sierra-Fortuny , Carla Bermudez-Carre , Mario Framil , Edgar Creus-Bachiller , Julen Viana-Errasti , Paula Rofes , Gemma Rocamora-Blanch , Lara Hidalgo-Peña , Lydia García-Serrano , Raúl Rigo-Bonnin , Lidia Feliubadaló , Jesús del Valle , Laura Calatayud , Francisco Morandeira , Conxi Lázaro , Xavier Solanich

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Abstract

Background

Neutralizing autoantibodies against type I interferons were strongly linked to severe COVID-19 in unvaccinated patients; however, this has yet to be evaluated in vaccinated individuals.

Objective

To analyze how these autoantibodies influences disease variability in vaccine breakthrough COVID-19 pneumonia patients.

Methods

Clinical and laboratory data; autoantibodies blocking interferon-α2 and –ω; and humoral response to SARS-CoV-2 vaccine were collected from all vaccinated COVID-19 pneumonia patients admitted from April 2021 to December 2022 at Bellvitge University Hospital, Spain.

Results

458 patients developed COVID-19 pneumonia despite an appropriate antibody response to SARS-CoV-2 vaccination. Autoantibodies neutralizing interferons were significantly more prevalent in patients with critical pneumonia compared to those with milder forms (8.8 % vs. 3.6 %; p = 0.037). Having these autoantibodies was an independent predictor for critical COVID-19 pneumonia (OR 2.88 [95 %CI 1.18–6.98]).

Conclusion

Vaccination considerably reduces the severity of COVID-19; however, patients with type I interferon autoantibodies remain at increased risk of severe disease.

Abstract Image

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中和I型干扰素的自身抗体仍然是接种疫苗患者发生COVID-19重症肺炎的重要危险因素

背景在未接种疫苗的患者中，针对 I 型干扰素的中和自身抗体与严重的 COVID-19 密切相关；然而，这一点尚未在接种疫苗的个体中进行评估。目的分析这些自身抗体如何影响疫苗突破 COVID-19 肺炎患者的疾病变异性。方法收集西班牙贝尔维奇大学医院 2021 年 4 月至 2022 年 12 月期间收治的所有接种过 COVID-19 疫苗的肺炎患者的临床和实验室数据、阻断干扰素-α2 和干扰素-ω的自身抗体以及对 SARS-CoV-2 疫苗的体液反应。中和干扰素的自身抗体在重症肺炎患者中的流行率明显高于轻症肺炎患者（8.8% 对 3.6%；P = 0.037）。结论接种疫苗可大大降低 COVID-19 的严重程度；但是，I 型干扰素自身抗体患者罹患重症的风险仍然会增加。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Clinical immunology 医学-免疫学

CiteScore

12.30

自引率

1.20%

发文量

212

审稿时长

34 days

期刊介绍： Clinical Immunology publishes original research delving into the molecular and cellular foundations of immunological diseases. Additionally, the journal includes reviews covering timely subjects in basic immunology, along with case reports and letters to the editor.