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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.
Fujii, Hiroyuki; Tsuji, Taisuke; Yuba, Tatsuya; Tanaka, Shunya; Suga, Yoshifumi; Matsuyama, Aosa; Omura, Ayaka; Shiotsu, Shinsuke; Takumi, Chieko; Ono, Seiko; Horiguchi, Masahito; Hiraoka, Noriya.
  • Fujii H; Department of Respiratory Medicine, Japanese Red Cross Kyoto Daiichi Hospital, 15-749 Honmachi, Higashiyama, Kyoto, Japan. fujii0825@gmail.com.
  • Tsuji T; Department of Respiratory Medicine, Japanese Red Cross Kyoto Daiichi Hospital, 15-749 Honmachi, Higashiyama, Kyoto, Japan.
  • Yuba T; Department of Respiratory Medicine, Japanese Red Cross Kyoto Daiichi Hospital, 15-749 Honmachi, Higashiyama, Kyoto, Japan.
  • Tanaka S; Department of Infection Control, Japanese Red Cross Kyoto Daiichi Hospital, Kyoto, Japan.
  • Suga Y; Department of Respiratory Medicine, Japanese Red Cross Kyoto Daiichi Hospital, 15-749 Honmachi, Higashiyama, Kyoto, Japan.
  • Matsuyama A; Department of Respiratory Medicine, Japanese Red Cross Kyoto Daiichi Hospital, 15-749 Honmachi, Higashiyama, Kyoto, Japan.
  • Omura A; Department of Respiratory Medicine, Japanese Red Cross Kyoto Daiichi Hospital, 15-749 Honmachi, Higashiyama, Kyoto, Japan.
  • Shiotsu S; Department of Respiratory Medicine, Japanese Red Cross Kyoto Daiichi Hospital, 15-749 Honmachi, Higashiyama, Kyoto, Japan.
  • Takumi C; Department of Respiratory Medicine, Japanese Red Cross Kyoto Daiichi Hospital, 15-749 Honmachi, Higashiyama, Kyoto, Japan.
  • Ono S; Department of Clinical Oncology, Japanese Red Cross Kyoto Daiichi Hospital, Kyoto, Japan.
  • Horiguchi M; Department of Respiratory Medicine, Japanese Red Cross Kyoto Daiichi Hospital, 15-749 Honmachi, Higashiyama, Kyoto, Japan.
  • Hiraoka N; Department of Clinical Oncology, Japanese Red Cross Kyoto Daiichi Hospital, Kyoto, Japan.
Clin Rheumatol ; 39(11): 3171-3175, 2020 Nov.
Article in English | MEDLINE | ID: covidwho-730357
ABSTRACT
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.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: Pneumonia, Viral / Respiratory Insufficiency / Antibodies, Antinuclear / Lung Diseases, Interstitial / Coronavirus Infections Type of study: Case report / Prognostic study Topics: Long Covid Language: English Journal: Clin Rheumatol Year: 2020 Document Type: Article Affiliation country: S10067-020-05359-y

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Pneumonia, Viral / Respiratory Insufficiency / Antibodies, Antinuclear / Lung Diseases, Interstitial / Coronavirus Infections Type of study: Case report / Prognostic study Topics: Long Covid Language: English Journal: Clin Rheumatol Year: 2020 Document Type: Article Affiliation country: S10067-020-05359-y