Infectious Disease

Persistent positive ANA tests 1 year after COVID-19 may predict long COVID symptoms

January 03, 2023

2 min read

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Disclosures:
Mukherjee reports no relevant financial disclosures. Please see the study for all other authors’ relevant financial disclosures.

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Consistently positive antinuclear antibody tests at 12 months following acute SARS-CoV-2 infection may predict long-term symptoms and inflammation, according to data published in the European Respiratory Journal.

“Although long COVID is now recognized by bodies like the World Health Organization, we still know very little about why it develops or how we can help patients,” Manali Mukherjee, PhD, of McMaster University, in Ontario, Canada, said in a press release from the European Respiratory Society highlighting the findings. “I’m a respiratory researcher with a background in studying the immune system and when I experienced the symptoms of long COVID first-hand, I began to wonder about the role of the immune system in this condition.”

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Consistently positive antinuclear antibody tests at 12 months following acute SARS-CoV-2 infection may predict long-term symptoms and inflammation, according to data. Source: Adobe Stock

To investigate the association between antinuclear antibodies (ANA) in patients after COVID-19, Mukherjee and colleagues conducted a multicenter, observational study. Patients were enrolled between August 2020 and September 2021, and were required to make three visits related to the study at 3, 6 and 12 months after recovery. Patients were eligible for inclusion if they were aged 18 years or older and had a positive PCR test for COVID-19. Additionally, there could be no previous history of autoimmune disease. The researchers also recruited age- and sex-matched patients who never developed COVID-19.

The researchers assessed patient demographics and persistent COVID-19 symptoms at each post-recovery visit, including fatigue, cough and shortness of breath. The presence and quantification of anti- and extra-nuclear antibodies were also investigated for each patient, as were markers of inflammation, coagulation, vascular cell adhesion protein and C-reactive protein.

In all, the analysis included 106 patients with previous SARS-CoV-2 infections, 22 healthy matched controls and 34 patients who had other respiratory infections. Among the analyzed patients, those with COVID-19 demonstrated higher levels of detectable ANA, compared with the healthy controls and those with other respiratory diseases at 3 months (P < .001), according to the researchers. The presence of antibodies to U1-snRNP and anti-SS-B/La correlated with persistent fatigue (P < .028) and dyspnea (P < .003). Meanwhile, TNF, D-dimer, and IL-1 demonstrated the strongest correlation with symptoms following 12 months, the authors wrote.

“We know that certain infections can, in some cases, trigger longer-term autoimmune diseases such as rheumatoid arthritis,” Eva Polverino, MD, PhD, of the Vall d’Hebron University Hospital, in Barcelona, ​​Spain, said in the release. “This study adds to growing evidence that similar processes may be involved in long COVID. Further work in this area could increase our understanding of long COVID and how best to diagnose and treat the condition.”

References:

Long COVID patients show signs of autoimmune disease a year after infection. https://www.eurekalert.org/news-releases/965377. Sept. 21, 2022. Accessed Oct. 17, 2022.

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COVID-19 and Rheumatology

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