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Generation of Inhibitory Autoantibodies to ADAMTS13 in Coronavirus Disease 2019 (preprint)
medrxiv; 2021.
Preprint
in English
| medRxiv | ID: ppzbmed-10.1101.2021.03.18.21253869
ABSTRACT
Objectives:
It has recently been shown that von Willebrand factor (vWf) multimers may be a key driver of immunothrombosis in Coronavirus disease 2019 (COVID-19). Since COVID-19 is associated with an increased risk of autoreactivity, the present study investigates, whether the generation of autoantibodies to ADAMTS13 contributes to this finding.Design:
Observational prospective controlled multicenter study.Setting:
Blood samples and clinical data of patients with COVID-19 were collected regularly during hospitalization in the period from April to November 2020. Patients 90 patients with confirmed COVID-19 of mild to critical severity and 30 healthy controls participated in this study. Measuerements and MainResults:
Antibodies to ADAMTS13 occurred in 31 (34.4%) patients with COVID-19. Generation of ADAMTS13 antibodies was associated with a significantly lower ADAMTS13 activity (56.5%, interquartile range (IQR) 21.25 vs. 71.5%, IQR 24.25, p=0.0041), increased disease severity (severe or critical disease in 90% vs. 62.3%, p=0.0189), and a trend to a higher mortality (35.5% vs. 18.6%, p=0.0773). Median time to antibody development was 11 days after first positive SARS-CoV-2-PCR specimen.Conclusion:
The present study demonstrates for the first time, that generation of antibodies to ADAMTS13 is a frequent finding in COVID-19. Generation of these antibodies is associated with a lower ADAMTS13 activity and an increased risk of an adverse course of the disease suggesting an inhibitory effect on the protease. These findings provide a rationale to include ADAMTS13 antibodies in the diagnostic workup of SARS-CoV-2 infections.
Full text:
Available
Collection:
Preprints
Database:
medRxiv
Main subject:
Von Willebrand Diseases
/
Critical Illness
/
Coronavirus Infections
/
Severe Acute Respiratory Syndrome
/
COVID-19
/
Muscle Hypertonia
Language:
English
Year:
2021
Document Type:
Preprint
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