Transient expression of antinuclear RNP-A antibodies in patients with acute COVID-19 infection

Shuxia Zhou; Ravi Kaul; Kara L Lynch; Alan H B Wu; Roger P Walker

doi:10.1016/j.jtauto.2022.100175

Transient expression of antinuclear RNP-A antibodies in patients with acute COVID-19 infection

J Transl Autoimmun. 2022 Nov 24:5:100175. doi: 10.1016/j.jtauto.2022.100175. eCollection 2022.

Authors

Shuxia Zhou¹, Ravi Kaul¹, Kara L Lynch², Alan H B Wu², Roger P Walker¹

Affiliations

¹ Bio-Rad Laboratories, Hercules, CA, USA.
² Department of Laboratory Medicine, University of California, San Francisco, USA.

Abstract

Introduction: Viral infections have been implicated in the initiation of the autoimmune diseases. Recent reports suggest that a proportion of patients with COVID-19 develop severe disease with multiple organ injuries. We evaluated the relationship between COVID-19 severity, prevalence and persistence of antinuclear and other systemic and organ specific autoantibodies as well as SARS-CoV-2 infection specific anti-nucleocapsid (N) IgG antibodies and protective neutralizing antibody (Nab) levels.

Methods: Samples from 119 COVID-19 patients categorized based on their level of care and 284 healthy subjects were tested for the presence and persistence of antinuclear and other systemic and organ specific autoantibodies as well as SARS-CoV-2 and neutralizing antibody levels.

Results: The data shows significantly increased levels of anti RNP-A, anti-nucleocapsid and neutralizing antibody among patients receiving ICU care compared to non-ICU care. Furthermore, subjects receiving ICU care demonstrated significantly higher nucleocapsid IgG levels among the RNP-A positive cohort compared to RNP-A negative cohort. Notably, the expression of anti RNP-A antibodies is transient that reverts to non-reactive status between 20 and 60 days post symptom onset.

Conclusions: COVID-19 patients in ICU care exhibit significantly higher levels of transient RNP-A autoantibodies, anti-nucleocapsid, and SARS-CoV-2 neutralizing antibodies compared to patients in non-ICU care.

Keywords: ACE2, angiotensin-converting enzyme 2; ANA, antinuclear antibody; Antinuclear antibody; COVID-19; COVID-19, coronavirus disease 2019; ICU, intensive care unit; IFA, Immunofluorescence assay; MCTD, mixed connective tissue disease; N, SARS-CoV-2 nucleocapsid protein; Nab, neutralizing antibody; Neutralizing antibody; Nucleocapsid protein; PSO, post symptom onset; RNP-A; RNP-A, ribonucleoprotein A; SARS-CoV-2; SARS-CoV-2, severe acute respiratory syndrome coronavirus 2; sVNT, surrogate viral neutralization test.