Annals of Intensive Care | |
Auto-antibodies against type I IFNs in > 10% of critically ill COVID-19 patients: a prospective multicentre study | |
Research | |
Stéphane Gaudry1  Thibaut Belmondo2  Julien Mayaux3  Sophie Hue4  Florence Canoui-Poitrine5  Lauriane Segaux6  Mariem Ben Ahmed7  Paul Bastard8  Jean-Laurent Casanova8  Lucy Bizien8  Adrian Gervais8  Damien Roux9  Mélodie Parfait1,10  Elsa Moncomble1,11  Nicolas de Prost1,12  Romain Arrestier1,12  Armand Mekontso-Dessap1,12  Charles-Edouard Luyt1,13  Nicolas Fage1,14  Taï Pham1,14  Zakaria Ait-Hamou1,15  Hafid Ait-Oufella1,16  Tomas Urbina1,16  Guillaume Voiriot1,17  Elie Azoulay1,18  Raphael Clere-Jehl1,18  Raphaël Bellaïche1,19  Karim Dorgham2,20  Guy Gorochov2,21  | |
[1] Département de réanimation médico-chirurgicale, APHP Hôpital Avicenne, Bobigny, France;Département d’Hématologie et d’Immunologie Biologiques, Assistance Publique-Hôpitaux de Paris (AP-HP), Groupe Hospitalo-Universitaire Chenevier Mondor, Créteil, 94010, Paris, France;Groupe Hospitalier Pitié Salpêtrière, Assistance Publique Hôpitaux de Paris, Service de Pneumologie et Réanimation Médicale, Paris, France;INSERM, IMRB, Université Paris Est Créteil, Créteil, 94010, Paris, Cedex, France;Département d’Hématologie et d’Immunologie Biologiques, Assistance Publique-Hôpitaux de Paris (AP-HP), Groupe Hospitalo-Universitaire Chenevier Mondor, Créteil, 94010, Paris, France;INSERM, IMRB, Université Paris Est Créteil, Créteil, 94010, Paris, Cedex, France;Groupe Hospitalier Pitié Salpêtrière, Assistance Publique Hôpitaux de Paris, Service de Pneumologie et Réanimation Médicale, Paris, France;INSERM, IMRB, Université Paris Est Créteil, Créteil, 94010, Paris, Cedex, France;Unité de Recherche Clinique AP-HP, Hôpitaux Henri-Mondor, 94010, Creteil, Cedex, France;Imagine Institute, University of Paris, Paris, France;Laboratory of Human Genetics of Infectious Diseases, Necker Branch, INSERM U1163, Necker Hospital for Sick Children, Paris, France;Imagine Institute, University of Paris, Paris, France;St. Giles Laboratory of Human Genetics of Infectious Diseases, Rockefeller Branch, The Rockefeller University, New York, NY, USA;Médecine Intensive Réanimation, AP-HP, Hôpital Louis Mourier, DMU ESPRIT, 92700, Colombes, France;Service de Médecine Intensive Réanimation, Service de Réanimation Médicale, Hôpital Henri Mondor, Hôpitaux Universitaires Henri Mondor, Assistance Publique-Hôpitaux de Paris, Créteil, 94010, Paris, Cedex, France;Service de Médecine Intensive Réanimation, Service de Réanimation Médicale, Hôpital Henri Mondor, Hôpitaux Universitaires Henri Mondor, Assistance Publique-Hôpitaux de Paris, Créteil, 94010, Paris, Cedex, France;Groupe de Recherche Clinique CARMAS, Faculté de Santé de Créteil, Université Paris Est Créteil, Créteil, 94010, Paris, Cedex, France;Service de Médecine Intensive Réanimation, Service de Réanimation Médicale, Hôpital Henri Mondor, Hôpitaux Universitaires Henri Mondor, Assistance Publique-Hôpitaux de Paris, Créteil, 94010, Paris, Cedex, France;Groupe de Recherche Clinique CARMAS, Faculté de Santé de Créteil, Université Paris Est Créteil, Créteil, 94010, Paris, Cedex, France;INSERM, IMRB, Université Paris Est Créteil, Créteil, 94010, Paris, Cedex, France;Service de Médecine Intensive Réanimation, Sorbonne Université, Hôpitaux Universitaires Pitié Salpêtrière-Charles Foix, Assistance Publique-Hôpitaux de Paris (AP-HP), Paris, France;INSERM UMRS_1166-iCAN, Institute of Cardiometabolism and Nutrition, Paris, France;Service de Médecine Intensive-Réanimation, AP-HP, Hôpital de Bicêtre, DMU 4 CORREVE Maladies du Cœur et des Vaisseaux, FHU Sepsis, Groupe de Recherche Clinique CARMAS, Le Kremlin-Bicêtre, France;Service de Médecine Intensive-Réanimation, Hôpital Cochin, Assistance Publique-Hôpitaux de Paris (AP-HP), Centre & Université de Paris, Paris, France;Service de Médecine Intensive-Réanimation, Hôpital Saint-Antoine, Assistance Publique-Hôpitaux de Paris (AP-HP), Paris, France;Service de Médecine Intensive-Réanimation, Hôpital Tenon, Assistance Publique-Hôpitaux de Paris (AP-HP), Paris, France;Service de médecine intensive et réanimation, Hôpital Saint-Louis, Assistance Publique Des Hôpitaux de Paris, Paris, France;Service d’Anesthésie-Réanimation Chirurgicale, Assistance Publique-Hôpitaux de Paris, Hôpitaux Universitaires Henri Mondor, 94000, Créteil, France;Sorbonne Université, Inserm, Centre d’Immunologie et des Maladies Infectieuses (CIMI-Paris), 75013, Paris, France;Sorbonne Université, Inserm, Centre d’Immunologie et des Maladies Infectieuses (CIMI-Paris), 75013, Paris, France;Département d’Immunologie, Assistance Publique Hôpitaux de Paris (AP-HP), Hôpital Pitié-Salpêtrière, 75013, Paris, France; | |
关键词: COVID-19; Interferon; Auto-antibodies; Acute respiratory distress syndrome; | |
DOI : 10.1186/s13613-022-01095-5 | |
received in 2022-07-06, accepted in 2022-12-11, 发布年份 2022 | |
来源: Springer | |
【 摘 要 】
BackgroundAuto-antibodies (auto-Abs) neutralizing type I interferons (IFN) have been found in about 15% of critical cases COVID-19 pneumonia and less than 1% of mild or asymptomatic cases. Determining whether auto-Abs influence presentation and outcome of critically ill COVID-19 patients could lead to specific therapeutic interventions. Our objectives were to compare the severity at admission and the mortality of patients hospitalized for critical COVID-19 in ICU with versus without auto-Abs.ResultsWe conducted a prospective multicentre cohort study including patients admitted in 11 intensive care units (ICUs) from Great Paris area hospitals with proven SARS-CoV-2 infection and acute respiratory failure. 925 critically ill COVID-19 patients were included. Auto-Abs neutralizing type I IFN-α2, β and/or ω were found in 96 patients (10.3%). Demographics and comorbidities did not differ between patients with versus without auto-Abs. At ICU admission, Auto-Abs positive patients required a higher FiO2 (100% (70–100) vs. 90% (60–100), p = 0.01), but were not different in other characteristics. Mortality at day 28 was not different between patients with and without auto-Abs (18.7 vs. 23.7%, p = 0.279). In multivariable analysis, 28-day mortality was associated with age (adjusted odds ratio (aOR) = 1.06 [1.04–1.08], p < 0.001), SOFA score (aOR = 1.18 [1.12–1.23], p < 0.001) and immunosuppression (aOR = 1.82 [1.1–3.0], p = 0.02), but not with the presence of auto-Abs (aOR = 0.69 [0.38–1.26], p = 0.23).ConclusionsIn ICU patients, auto-Abs against type I IFNs were found in at least 10% of patients with critical COVID-19 pneumonia. They were not associated with day 28 mortality.
【 授权许可】
CC BY
© The Author(s) 2022
【 预 览 】
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