High levels of anti-SSA/Ro antibodies in COVID-19 patients with severe respiratory failure : a case-based review : High levels of anti-SSA/Ro antibodies in COVID-19

We treated two patients with severe respiratory failure due to coronavirus disease 2019 (COVID-19). Case 1 was a 73-year-old woman, and Case 2 was a 65-year-old-man. Neither of them had a history of autoimmune disease. Chest computed tomography scans before the antiviral therapy showed bilateral multiple patchy ground-glass opacities (GGO) consistent with COVID-19 pneumonia. The GGO regressed over the course of the antiviral treatment; however, new non-segmental patchy consolidations emerged, which resembled those of interstitial lung disease (ILD), specifically collagen vascular disease-associated ILD. We tested the patients' sera for autoantibodies and discovered that both patients had high anti-SSA/Ro antibody titers. In Case 1, the patient recovered with antiviral therapy alone. However, in Case 2, the patient did not improve with antiviral therapy alone but responded well to corticosteroid therapy (methylprednisolone) and made a full recovery. The relationship between some immunological responses and COVID-19 pneumonia exacerbation has been discussed previously; our discovery of the elevation of anti-SSA/Ro antibodies suggests a contribution from autoimmunity functions of the immune system. Although it is unclear whether the elevation of anti-SSA/Ro antibodies was a cause or an outcome of aggravated COVID-19 pneumonia, we hypothesize that both patients developed aggravated the COVID-19 pneumonia due to an autoimmune response. In COVID-19 lung injury, there may be a presence of autoimmunity factors in addition to the known effects of cytokine storms. In patients with COVID-19, a high level of anti-SSA/Ro52 antibodies may be a surrogate marker of pneumonia severity and poor prognosis.

Media Type:

Electronic Article

Year of Publication:

2020

Contained In:

Clinical rheumatology - Vol. 39, No. 11 (2020), p. 3171-3175

Language:

English

Contributors:

Fujii, Hiroyuki
Tsuji, Taisuke
Yuba, Tatsuya
Tanaka, Shunya
Suga, Yoshifumi
Matsuyama, Aosa
Omura, Ayaka
Shiotsu, Shinsuke
Takumi, Chieko
Ono, Seiko
Horiguchi, Masahito
Hiraoka, Noriya

Links:

Volltext

Keywords:

4QWG6N8QKH
Aged
Amides
Anti-SSA/Ro antibodies
Antibodies, Antinuclear
Antiviral Agents
Betacoronavirus
Case Reports
Ciclesonide
Coronavirus Infections
Coronavirus disease 2019 (COVID-19)
Corticosteroid
EW5GL2X7E0
Favipiravir
Female
Glucocorticoids
Guanidines
Humans
Hydroxychloroquine
Journal Article
Lung Diseases, Interstitial
Male
Methylprednisolone
Nafamostat
Pandemics
Pneumonia, Viral
Pregnenediones
Pyrazines
Recovery of Function
Respiratory Distress Syndrome, Adult
Respiratory Insufficiency
Review
S59502J185
SS-A antibodies
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)
Severity of Illness Index
Tomography, X-Ray Computed
X4W7ZR7023
Y25LQ0H97D

Notes:

Date Completed 23.10.2020

Date Revised 23.10.2020

published: Print-Electronic

Citation Status MEDLINE

Copyright: From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

Physical Description:

Online-Ressource

doi:

10.1007/s10067-020-05359-y

PMID:

32844364

PPN (Catalogue-ID):

NLM31511911X