Presence of Anti-MDA5 Antibody and Its Value for the Clinical Assessment in Patients With COVID-19: A Retrospective Cohort Study

Frontiers in Immunology

Lili Ren¹  Bin Cao²  Mengtao Li²  Yeming Wang³  Linghang Wang⁴  Jianwei Wang⁶  Li Guo⁶  Qian Wang⁶  Changzheng Liu⁷  Tao Jiao⁸  Geng Wang⁹  Xiaobo Lei⁹  Yan Zhao⁹  Xiaofeng Zeng⁹  Hong Chen⁹  Dingyu Zhang⁹  Chaojun Hu^1,10 

[1] Chinese Academy of Medical Sciences, National Clinical Research Center for Dermatologic and Immunologic Diseases, Ministry of Science &Technology, Key Laboratory of Rheumatology and Clinical Immunology, Ministry of Education, Beijing, China;Department of Pulmonary and Critical Care Medicine, Center of Respiratory Medicine, National Clinical Research Center for Respiratory Diseases, China-Japan Friendship Hospital, Beijing, China;Department of Respiratory Medicine, Capital Medical University, Beijing, China;Department of Respiratory and Critical Care Medicine, West China Hospital, Sichuan University, Chengdu, China;;Department of Rheumatology, Peking Union Medical College Hospital, Peking Union Medical College &Institute of Respiratory Medicine, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, China;Laboratory of Infectious Diseases Center of Beijing Ditan Hospital, Capital Medical University, Beijing, China;National Health Commission of the People's Republic of China (NHC), Key Laboratory of Systems Biology of Pathogens and Christophe Merieux Laboratory, Institute of Pathogen Biology, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China;The Second Affiliated Hospital of Harbin Medical University, Harbin, China;

关键词: anti-melanoma differentiation-associated gene 5 (MDA5) antibody;    COVID-19;    dermatomyositis;    acute respiratory distress syndrome (ARDS);    innate immunity;    autoimmune;   

DOI  :  10.3389/fimmu.2021.791348

来源: DOAJ

【 摘 要 】

BackgroundStriking similarities have been found between coronavirus disease 2019 (COVID-19) and anti-melanoma differentiation-associated gene 5 (MDA5) antibody (Ab)-related dermatomyositis, implying a shared autoinflammatory aberrance. Herein, we aim to investigate whether the anti-MDA5 Ab is present in COVID-19 and correlates with the severity and adverse outcome of COVID-19 patients.Methods and FindingsWe retrospectively recruited 274 adult inpatients with COVID-19 in this study, including 48, 164, and 62 cases of deaths, severe, and non-severe patients respectively. The anti-MDA5 Ab was determined by ELISA and verified by Western Blotting, which indicated that the positive rate of anti-MDA5 Ab in COVID-19 patients was 48.2% (132/274). The clinical and laboratory features, as well as outcomes between patients with positive and negative anti-MDA5 Ab were compared and we found that the anti-MDA5 Ab positive patients tended to represent severe disease (88.6% vs 66.9%, P<0.0001). We also demonstrated that the titer of anti-MDA5 Ab was significantly elevated in the non-survivals (5.95 ± 5.16 vs 8.22 ± 6.64, P=0.030) and the positive rate was also higher than that in the survivals (23.5% vs 12.0%, P=0.012). Regarding severe COVID-19 patients, we found that high titer of anti-MDA5 Ab (≥10.0 U/mL) was more prevalent in the non-survivals (31.2% vs 14.0%, P=0.006). Moreover, a dynamic analysis of anti-MDA5 Ab was conducted at different time-points of COVID-19, which revealed that early profiling of anti-MDA5 Ab could distinguish severe patients from those with non-severe ones.ConclusionsAnti-MDA5 Ab was prevalent in the COVID-19 patients and high titer of this antibody is correlated with severe disease and unfavorable outcomes.

【 授权许可】

Unknown