Abstract
Autoantibodies to multiple targets are found during acute COVID-19. Whether all, or some, persist after 6 months, and their correlation with sustained anti-SARS-CoV-2 immunity, is still controversial. Herein, we measured antibodies to multiple SARS-CoV-2 antigens (Wuhan-Hu-1 nucleoprotein (NP), whole spike (S), spike subunits (S1, S2 and receptor binding domain (RBD)) and Omicron spike) and 102 human proteins with known autoimmune associations, in plasma from healthcare workers 8 months post-exposure to SARS-CoV-2 (n=31 with confirmed COVID-19 disease and n=21 uninfected controls (PCR and anti-SARS-CoV-2 negative) at baseline). IgG antibody responses to SARS-CoV-2 antigens were significantly higher in the convalescent cohort than the healthy cohort, highlighting lasting antibody responses up to 8 months post-infection. These were also shown to be cross-reactive to the Omicron variant spike protein at a similar level to lasting anti-RBD antibodies (correlation r=0.89). Individuals post COVID-19 infection recognised a common set of autoantigens, specific to this group in comparison to the healthy controls. Moreover, the long-term level of anti-Spike IgG was associated with the breadth of autoreactivity post-COVID-19. There were further moderate positive correlations between anti-SARS-CoV-2 responses and 11 specific autoantigens. The most commonly recognised autoantigens were found in the COVID-19 convalescent cohort. Although there was no overall correlation in self-reported symptom severity and anti-SARS-CoV-2 antibody levels, anti-calprotectin antibodies were associated with return to healthy normal life 8 months post infection. Calprotectin was also the most common target for autoantibodies, recognized by 22.6% of the overall convalescent cohort. Future studies may address whether, counter-intuitively, such autoantibodies may play a protective role in the pathology of long-COVID-19.
Keywords: COVID-19; SARS-CoV-2; antibodies; autoantibodies; autoimmunity.
【저자키워드】 COVID-19, antibodies, SARS-CoV-2, Autoimmunity, autoantibodies, 【초록키워드】 IgG, Autoimmunity, pathology, Immunity, antibody, Antibody Response, omicron, anti-SARS-CoV-2, healthcare worker, Receptor binding domain, COVID-19 disease, Protein, Cohort, IgG antibody, PCR, anti-SARS-CoV-2 antibody, COVID-19 infection, response, plasma, target, Autoimmune, SARS-CoV-2 antigen, convalescent, correlation, moderate, autoantigen, breadth, autoantibody, Anti-RBD antibody, cross-reactive, Autoantigens, Post-infection, subunit, individual, positive correlation, protective role, symptom severity, acute COVID-19, post infection, Wuhan-Hu-1, Future, controls, variant spike, shown, healthy, significantly higher, sustained, associations, uninfected control, highlighting, baseline, human protein, the healthy, 【제목키워드】 spike, Clinical outcome, Protein, autoantigen, autoantibody,