tetano
Editor, Senior Moderator
Front Immunol
. 2021 Dec 20;12:791348.
doi: 10.3389/fimmu.2021.791348. eCollection 2021.
Presence of Anti-MDA5 Antibody and Its Value for the Clinical Assessment in Patients With COVID-19: A Retrospective Cohort Study
Geng Wang[SUP] 1 2 [/SUP], Qian Wang[SUP] 3 [/SUP], Yeming Wang[SUP] 4 5 6 [/SUP], Changzheng Liu[SUP] 2 [/SUP], Linghang Wang[SUP] 7 [/SUP], Hong Chen[SUP] 8 [/SUP], Tao Jiao[SUP] 2 [/SUP], Chaojun Hu[SUP] 3 [/SUP], Xiaobo Lei[SUP] 2 [/SUP], Li Guo[SUP] 2 [/SUP], Lili Ren[SUP] 2 [/SUP], Mengtao Li[SUP] 3 [/SUP], Yan Zhao[SUP] 3 [/SUP], Xiaofeng Zeng[SUP] 3 [/SUP], Dingyu Zhang[SUP] 9 [/SUP], Bin Cao[SUP] 4 5 6 [/SUP], Jianwei Wang[SUP] 2 [/SUP]
Affiliations
Abstract
Background: Striking 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 findings: We 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.
Conclusions: Anti-MDA5 Ab was prevalent in the COVID-19 patients and high titer of this antibody is correlated with severe disease and unfavorable outcomes.
Keywords: COVID-19; acute respiratory distress syndrome (ARDS); anti-melanoma differentiation-associated gene 5 (MDA5) antibody; autoimmune; dermatomyositis; innate immunity.
. 2021 Dec 20;12:791348.
doi: 10.3389/fimmu.2021.791348. eCollection 2021.
Presence of Anti-MDA5 Antibody and Its Value for the Clinical Assessment in Patients With COVID-19: A Retrospective Cohort Study
Geng Wang[SUP] 1 2 [/SUP], Qian Wang[SUP] 3 [/SUP], Yeming Wang[SUP] 4 5 6 [/SUP], Changzheng Liu[SUP] 2 [/SUP], Linghang Wang[SUP] 7 [/SUP], Hong Chen[SUP] 8 [/SUP], Tao Jiao[SUP] 2 [/SUP], Chaojun Hu[SUP] 3 [/SUP], Xiaobo Lei[SUP] 2 [/SUP], Li Guo[SUP] 2 [/SUP], Lili Ren[SUP] 2 [/SUP], Mengtao Li[SUP] 3 [/SUP], Yan Zhao[SUP] 3 [/SUP], Xiaofeng Zeng[SUP] 3 [/SUP], Dingyu Zhang[SUP] 9 [/SUP], Bin Cao[SUP] 4 5 6 [/SUP], Jianwei Wang[SUP] 2 [/SUP]
Affiliations
- PMID: 34987516
- PMCID: PMC8720853
- DOI: 10.3389/fimmu.2021.791348
Abstract
Background: Striking 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 findings: We 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.
Conclusions: Anti-MDA5 Ab was prevalent in the COVID-19 patients and high titer of this antibody is correlated with severe disease and unfavorable outcomes.
Keywords: COVID-19; acute respiratory distress syndrome (ARDS); anti-melanoma differentiation-associated gene 5 (MDA5) antibody; autoimmune; dermatomyositis; innate immunity.