ABSTRACT
Introduction: Evidence from clinical trials strongly supports the safety and efficacy of the different COVID-19 vaccines. Indeed, the risk to develop a severe form of the disease, possibly leading to death, it is highly decreased in fully vaccinated individuals. Nowadays, vaccines effects and their possible ability to stimulate an autoimmune reaction are still poorly understood. The aim of this study was to check the development and /or persistence of antinuclear antibodies (ANA) in healthcare workers (HCPs) after mRNA based anti-SARS CoV-2 vaccines. Method(s): In this study, 77 HCPs were considered (60 females and 17 males, age range 26-67 years, median age 48) without any history of COVID-19 infection. All the subjects were vaccinated with 2 doses of BioNtech/Pfizer BNT162b2 mRNA. Furthermore, half of them received a third dose of the same vaccine, whereas the other half of Moderna (Spikevax). Blood Samples were collected before the inoculation of the vaccine (T0), at 3 (T1) and 12 months (T2) after the first dose. Therefore, at T1 all the subjects received two doses of vaccine and at T2 three doses. ANA presence was evaluated using indirect immunofluorescence on Hep-2 cells (EUROIMMUN test kit) at dilutions: 1:80, 1:160, 1:320, 1:640. Fisher and Wilcoxon statistical tests were performed using GraphPad Prism 9 Software. Result(s): Among 77 subjects enrolled, at T0 25 were positive for ANA (23 maintained this positivity also at T1 and T2) and 52 were negative. At T1, 46/52 remained negative, whereas 6/52 became ANA positive (5 maintained this positivity also at T2). At T2, 30/46 were still negative, instead 16/46 became ANA positive. In addition, from T1 to T2, it has been observed a statistically significant increase of ANA presence. Conclusion(s): Our results suggest that mRNA based anti-SARS CoV-2 vaccines seem to induce the onset of de novo ANA in 22/77 (28,57%) of subjects and that the percentage of positivity seems to directly correlate to the number of vaccine expositions: 6/77 (7,79%) after 2 doses;and 16/77 (20,78%) after 3 doses.
ABSTRACT
Recent studies highlight the evidence of autoantibodies in patients affected by Corona Virus Disease-2019 (COVID-19). We evaluated whether severe acute respiratory syndrome (SARS-CoV-2) stimulates autoantibody production and contributes to autoimmunity activation. We enrolled 40 adult patients (66.8 years mean age) admitted to Alessandria hospital between March and April 2020 with a confirmed COVID-19 diagnosis by real-time polymerase chain reaction (RT-PCR) and no previously clinical record of autoimmune disease. 40 blood donors were analyzed for the same markers and considered as healthy controls. All hospitalized patients had high levels of common inflammatory markers, such as C Reactive Protein, Lactate Dehydrogenase, ferritin and creatinine. Interleukin-6 concentrations were also increased, supporting the major role of this interleukin during COVID-19 infection. Lymphocytes number was generally lower compared to healthy individuals. All the patients were also screened for the most common autoantibodies. We found a significant prevalence of ANA (57,5%), ANCA (25%), and ASCA IgA (25%) antibodies in COVID-19 patients compared to healthy controls. We observed that patients having a de novo autoimmune response had the worst acute viral disease prognosis and outcome. Our results sustain the hypothesis that COVID-19 virus might break the body tolerance to itself and stimulate autoimmune responses, suggesting they were directly related to viral infection, instead of being a preexisting condition. The observed increase of autoantibodies remained stable in six-month follow-up of COVID-19 patients. Moreover, preliminary data indicate in a few patients the apparence of clinical manifestations suggestive of autoimmune disease onset. More study will be needed to find out whether these autoimmune profiles persist in COVID-19 affected patients.